• Allergic rhinitis is common.
• This systematic review outlines the evidence regarding montelukast in allergic rhinitis and provides a meta-analysis of its efficacy.
• The evidence suggests that montelukast does reduce nasal symptom score by 3.4% (95% CI: 2.5% to 4.2%) when compared with placebo.
• Montelukast is not as effective as topical nasal steroids or antihistamines and should therefore be regarded as second line therapy.
• When used, montelukast should be used in combination with an antihistamine.