Roaches, especially the German Cockroach, are a very common pest in crowded cities worldwide. Recent studies have shown exposure to roach droppings as a major risk factor for the development of allergies and asthma in the inner-city. Avoidance consists of roach baits and traps, extermination and cleanliness. This includes, not leaving food out in open containers, washing dishes after each meal, and keeping cupboards free of food debris. Unfortunately, one can't encourage cleanliness in their neighbors! Patients who are not responsive can be treated with medications and allergy immunization.