 House dust mite, HDM, is a major indoor-ero allergen worldwide that causes allergic diseases such as allergic rhinoconjunctivitis, allergic asthma, atopic eczema, and other skin allergies. Although allergen-specific immunotherapy, AIT, is the only potential disease modifying treatment for HDM allergic subjects, its underuse is due to a lack of universally accepted allergen standardization and limited clinical studies on safety and efficacy. However, ongoing research in the allergy field aims to improve AIT's efficacy, safety, standardization, and strategy through recently published trials and meta-analyses. This article was offered by Lin Yang and Rongfei Xu.