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This article discusses the successful treatment of refractory heat urticaria (HU) with omalizumab, a medication typically used for chronic spontaneous urticaria (CSU). HU is a rare and difficult-to-treat form of chronic inducible urticaria that develops in response to heat exposure. The article presents two cases of patients with refractory HU who experienced significant improvement in symptoms after receiving omalizumab treatment. Omalizumab works by reducing mast cell activation and histamine release. The findings suggest that omalizumab could be a safe and effective treatment option for HU patients who do not respond to conventional therapies. [Extracted from the article]