(3-Lactam hypersensitivity is the most frequently self-reported drug hypersensitivity reaction. However, most of these patients are not truly allergic. The label of B.Lactam allergy is associated with multiple adverse outcomes, including mortality, increased costs, and hospital stay; therefore, healthcare practitioners should try to eliminate this label, when possible, in addition to knowing what safe antibiotic alternatives exist depending on the degree of risk, if the allergy is confirmed. Aim:This review presents the most critical aspects of beta-lactams allergy regarding relevance, pathophysiological mechanisms, diagnosis, and management, emphasizing cross-reaction risk. Methods: Narrative review of literature. Conclusion: According to the literature review results, we propose a management algorithm for hospitalized patients.