OBJECTIVES: To examine recent anti-allergic drug utilization patterns in adult patients with allergic rhinitis using National Ambulatory Care Survey data. METHODS: Data for this study was obtained from the 2006 and 2007 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) public use data files. Visits with a primary diagnosis of allergic rhinitis in adults (age >18 years) were identified. Descriptive weighted statistics was used to examine utilization patterns of various anti-allergic medications. A multivariate survey logistic was conducted to determine demographic and geographic variations associated with anti-allergic medication use in patients with allergic rhinitis. RESULTS: Allergic rhinitis accounted for 18.6 million adult ambulatory care visits in the United States. The majority of the visits were made by females (61.6%), whites (84.8%), and involved specialists (59.9%). Anti-allergic medications were prescribed in 55.1% (95%CI 39.2% -71.0%) of the total diagnosed visits. Antihistamines were the most commonly prescribed anti-allergic medication (37.4%) (95%CI 32.4%-46.5%) followed by intranasal steroids (28.3%) (95%CI 23.2%-31.8%). Topical nasal antihistamines and decongestants (7.8%) (95%CI 2.7%-9.9%), leukotrienes (6.3%) (95%CI 5.2%-6.8%), corticosteroids (3.4%) (95%CI 1.3%-4.3%), and oral decongestants (1.52%) (95%CI 0.4%-2.1%) were the least prescribed anti-allergic medications. The multivariate logistic regression revealed that geographic region of the office visits was significantly associated with medication use. Outpatient visits in the Midwest (Odds Ratio (OR) 5.16, 95%CI 1.50-17.67), South (OR 6.3, 95%CI 2.03-19.5), and West (OR 9.16, 95%CI 2.39-35.11) regions were more likely to be prescribed anti-allergic medications compared to those in the Northeast region. CONCLUSIONS: Anti-allergic medications were prescribed in over half of adult allergic rhinitis visits in the U.S. The findings highlight geographical variations in anti-allergic medication use for allergic rhinitis. Comprehensive research is needed to understand the reasons for geographic variation in the medication use for allergic rhinitis.