The shortage of Allergy & Immunology providers in the United States restricts access to specialty care. Telemedicine has the potential to expand access beyond physical locations, however, little is known regarding patient preferences for tele-allergy or the ability to successfully manage atopic conditions virtually. This retrospective analysis of a tele-allergy program at the Veterans Health Administration demonstrates that tele-allergy can provide efficient allergy care for veterans, including rural patients, although some reliance on local ancillary services was necessary. A hybrid model of virtual and in-person care is likely needed in Allergy & Immunology to overcome geographical barriers and optimize resource allocation.