Pollen allergy is characterized by seasonal allergic manifestations affecting patients during the plant pollen season. The aim of this study was to analyze the Betulaceae pollen pattern in Zagreb (2002-2005) and to determine the incidence of sensitization to these pollen types in patients with seasonal respiratory allergy. Twenty-four-hour pollen counts were carried out using volumetric procedure. Skin prick test were performed on a total of 864 patients aged 18-80< in Zagreb between 2 January – 31 December 2004. Pollen of the representatives of the family Betulaceae accounted for a signifi cant proportion of total pollen (34% on an average), predominated by Betula pollen and considerably lower proportion of Alnus sp. and Corylus sp. pollen. Alder and hazel pollen fi rst occurred in the air in February throughout the study period. The highest airborne pollen concentration of these taxa was recorded in February and March. The birch pollen season generally peaked in April. Only 2.67% of patients showed birch pollen monosensitization. The proportion of patients with polysensitization to Betulaceae pollen was considerably greater (12.88%), whereas polysensitization to Betulaceae, Poaceae and Ambrosia pollen was recorded in the highest proportion of patients (26.23%). According to age, the highest and lowest rate of allergy was recorded in the 31-50 and >51 age groups, respectively (46.22% vs 23.12%). Female predominance was observed across all age groups. The patients with monosensitization to birch pollen had the most severe symptoms in April. In the patients with poylsensitization to alder, hazel and birch pollen who developed cross-reaction, initial symptoms occurred as early as February, with abrupt exacerbation in March and April. The most severe condition was observed in the patients allergic to birch, hazel, alder, grass and ragweed pollen, with symptoms present throughout the year and exacerbation in spring and late summer months