Background: Autologous serum skin test (ASST) evaluates the presence of any serum histamine-releasing factors and histamine-releasing autoantibodies. Autologous serum therapy (AST) is a therapy in which repeated injections of autologous serum are administered intramuscularly for treatment of chronicspontaneous urticaria (CSU). The aim of this study is to evaluate the advantages and compare the results of the ASST and the efficacy of AST in CSU patients.Methods: We included a total of 39 patients that presented with urticaria of more than 6 weeks duration in this study. Patients who suffered from acute urticaria, urticarial vasculitis, physical urticaria, and other systemic diseases known to cause urticaria were excluded. Standard tools and techniques were used to prepare autologous serum, injection of the serum, and interpretation of the results. The test result was implicated as positive and negative ASST.