Food allergen oral immunotherapy (OIT) is an experimental, immune-modifying therapy that may induce clinical desensitization in some patients. OIT is still in early phase clinical research, but some provider may offer OIT as a clinical service. To understand the current practices of allergists performing OIT an on-line survey was emailed to members of the American Academy of Allergy Asthma and Immunology. Among 442 respondents, 61 (13.8%) reported participating in OIT, including 28 in non-academic settings. Informed consent for OIT was obtained by 91.3%, IRB approval by 47.7% and Investigational New Drug (IND) approval by 38.1%. Compared to non-academic participants, more academic participants used peanut OIT, obtained IRB and IND (p <0.0001 respectively), and challenged patients prior to entry (p=0.008). More non-academic providers billed the patient or insurance for reimbursement (p<0.0001). Low reported regard for the importance for FDA approval or a standardized product (increased odds), and high regard for better safety data (decreased odds) were associated with considering to offer OIT as a service. Significant differences exist in OIT occurring in academic vs. non-academic settings. Further assessment is needed regarding the different motivations and practice styles among providers offering OIT, and those considering doing so.