In this review we provide an overview on the latest knowledge in the prevention and active management of peanut allergy. The rise in incidence of food allergy has generated new challenges in the management of affected individuals. Strategies to counteract the increase in prevalence of peanut allergy can be considered as a pyramid, beginning with primary prevention of those at riskthrough earlier introduction of peanut into the infant diet, to secondary prevention of peanut-sensitised childrenthroughimprovements in the correct diagnosis of peanut allergy and finally to thetreatment of children with proven peanut allergy.Conclusion: With theparadigm shift towards an active management, peanut allergy should no longer be seen as a life sentence.