The benefits obtained from H1 antihistamines often vary depending upon their usage pattern. Given the number of choices and wide availability of antihistamines, choosing the right agent that will provide optimum effects with a least risk for adverse events is essential. Hence the present study was undertaken to evaluate the pattern of H1- antihistamine usage in dermatology, in order to identify any irrationality and to suggest measures for their better and rational use. 112 case files belonging to patients admitted in the department of dermatology over a period of one year were analysed. The data thus collected was expressed in terms of averages, ratios and proportions. On analysis it was found that antihistamines were prescribed to 68.75% (77/112) patients at an average of 1.71 antihistamine preparations per patient. 85% of all medications were prescribed by using brand names. Oral route was preferred in 61% (47/77) of the patients and around 37.66% (29/77) patients received both oral and injectable forms. Hydroxyzine was the most preferred oral antihistamine in 54.54% (42/77) of the patients followed by levocetrizine in 40% (31/77) and pheniramine maleate in 13% of the patients (10/77). Educational interventions among the doctors as well as students should be carried out to in order to promote rational use of H1- antihistamines.