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Background: Chronic urticaria (CU) is a common disease which represents a considerable burden for many patients. The current urticaria guideline describes the evidence-based diagnosis and treatment of CU. In addition, however, questions often arise in everyday practice that are not addressed by the guideline., Methods: In May 2020, a digital meeting with German urticaria experts was held, in which practical aspects of CU treatment were discussed and supporting aids for everyday clinical treatment formulated. The resulting advice in this document focus on practical questions and the available literature and experiences of the participants., Results: The diagnosis of CU can be made in a short time by means of a thorough anamnesis, a physical examination, and a basic laboratory chemical diagnosis. For this purpose, practical recommendations for everyday practice are given in this paper. An extended diagnosis is only indicated in a few cases and should always be carried out in parallel with an effective therapy. In general, CU should always be treated in the same way, regardless of whether wheals, angioedema or both occur. Symptomatic therapy should be carried out according to the treatment steps recommended by the guidelines. This publication provides practical advice on issues in everyday practice, such as the procedure in the current coronavirus disease 2019 (COVID-19) pandemic, the cardiac risk under higher dosed H1 antihistamines, the self-administration of omalizumab as well as vaccination under omalizumab therapy. In addition to treatment recommendations, topics such as documentation in the practice and family planning with urticaria will be discussed., Discussion: These supporting treatment recommendations serve as an addendum to the current CU guideline and provide support in dealing with CU patients in everyday practice. The aim is to ensure that patients suffering from CU achieve complete freedom of symptoms with the help of an optimal therapy., Supplementary Information: The online version of this article (10.1007/s40629-021-00162-w) contains supplementary material, which is available to authorized users., Competing Interests: Conflict of interestA. Bauer received fees for lectures and advisory boards of Novartis, Biofrontera, Shire/Takeda and Leo Pharma as well as research support from Novartis during the last three years. She has been involved in clinical trials with drugs from Novartis, Lilly, Regeneron, Sanofi, Leo Pharma, and Genetec. H. Dickel received fees from Novartis for lectures and advisory boards. He is also involved as PI in clinical studies with preparations from Novartis and Leo Pharma. T. Jakob has received fees for lectures and advisory boards from Novartis, ALK-Abéllo, Allergopharma, Bencard, Thermo Fischer and Celegene, as well as research support from Novartis and ALK-Abéllo. He is also a member of the extended board of the German Society for Allergology and Clinical Immunology and editor of the Allergo Journal and Allergo Journal International. A. Kleinheinz received financial support from Novartis, LEO, Sanofi, Galderma, Abbvie, Janssen, Medac, Almirall, Amgen, Celgene, Genentech, GSK, Lilly, Parexel, Pfizer and proinnovera as a speaker and for participation in clinicial studies. U. Lippert received fees for lectures or advisory boards lasting several hours in the last three years from Novartis, Shire/Takeda, ALK-Abéllo, Meda Pharma GmbH and Sanofi. She received research grants and consulting fees from Novartis and travel expenses from Novartis and Shire/Takeda. She has also been involved as LKP and PI in clinical trials with preparations from Regeneron, Sanofi and Novartis. M. Metz received fees as speaker and/or consultant for Amgen, Aralez, argenx, Moxie, Novartis, Roche, Sanofi and Uriach. S. Schliemann is an investigator in studies by Novartis Pharma GmbH, Sanofi GmbH, Eli Lilly and Company Limited, LEO Pharma GmbH, Pierre Fabre Dermo-Cosmetique, has received lecture fees from Novartis Pharma GmbH, Sanofi GmbH, LEO Pharma GmbH and HAL Allergy GmbH and research support from Novartis Pharma GmbH. U. Schwichtenberg: AbbVie Deutschland GmbH, Almirall Hermal GmbH, Amgen, Beiersdorf Derma Medical GmbH, Celgene GmbH, Dermapharm GmbH, Janssen Cilag GmbH, Johnson & Johnson GmbH, LEO Pharma GmbH, L’Oréal GmbH, MEDA Pharma GmbH, Merz Pharmaceuticals GmbH, MSD SHARP & DOHME GmbH, Novartis Pharma GmbH, and Pfizer GmbH, Sanofi-Aventis Deutschland GmbH—fees for lectures, advisory boards, study participation, Medical Project Design GmbH Shareholder and Managing Director, Professional Association of German Dermatologists Bremen State Chairman, Association of Statutory Health Insurance Physicians Bremen Member of the Assembly of Representatives and Chairman of the Honorarium Distribution Scale Committee, Member of the Finance Committee. P. Staubach is or recently was a speaker and/or advisor for and/or has received research funding from AbbVie, Allergika, Almirall, Amgen, Beiersdorf, Biocryst, Biogen Idec, BMS, Boehringer-Ingelheim, Celgene, CSL-Behring, Eli-Lilly, Galderma, Hexal, Janssen, Klosterfrau, LEO-Pharma, LETI-Pharma, L’Oreal, Novartis, Octapharma, Pfizer, Pflüger, Pharming, Regeneron, Shire, Takeda, Regeneron, Sanofi-Genzyme und UCB Pharma. E. Valesky has received honours for lectures and consultancy work for the companies Novartis, Bencard, Alk-Abello, JUZO, Kreussler and Sigvaris over the last three years. N. Wagner received fees for lectures or advisory boards lasting several hours in the last three years from Novartis, Shire/Takeda, ALK-Abéllo, Allergopharma, Abbvie, as well as research support from Novartis. In addition, she was involved as PI in clinical trials with Novartis products. B. Wedi received fees for lectures or advisory boards lasting several hours over the last three years from Novartis, Shire/Takeda, ALK-Abéllo, Bencard, CSL-Behring, HAL-Allergy and Leo Pharma as well as research support from Shire/Takeda. She has also been involved as LKP or PI in clinical trials with Novartis products. M. Maurer is or recently was a speaker and/or advisor for and/or has received research funding from Allakos, Amgen, Aralez, ArgenX, AstraZeneca, Celldex, Centogene, CSL Behring, FAES, Genentech, GIInnovation, Innate Pharma, Kyowa Kirin, Leo Pharma, Lilly, Menarini, Moxie, Novartis, Roche, Sanofi/Regeneron, Third HarmonicBio, UCB, and Uriach., (© The Author(s) 2021.)