The purpose of this article was to review the literature on omalizumab’s effects, safety and use in children, with a focus on asthma. Omalizumab, an IgE-binding agent, affects many aspects of asthma. It is known by now that omalizumab reduces the amount of eosinophils, IgE+, CD4+, CD8+ cells in the respiratory mucosa, and the expression of FcεRI on basophils and dendritic cells. It is possible that omalizumab also impedes airway remodelling. In a large number of patients, omalizumab as an add-on therapy enables to reduce the daily dose of inhaled corticosteroids, however, it does not improve pulmonary function. Treating asthma with omalizumab reduces exacerbation rate and the need for hospitalization and makes it is possible for some children to stop their inhaled corticosteroid treatment altogether. The most frequent side effects of anti-IgE are headache and upper respiratory infections. Omalizumab is efficient in treating moderate to severe allergic asthma. It can be safely used in patients over 6 years old.