<h3>Introduction</h3> Solar urticaria is a rare condition characterized by the development of hives upon exposure to sunlight. Treatment is challenging, usually involving antihistamines and sun avoidance. Recent case series suggest a role for omalizumab, an anti-IgE monoclonal antibody, in treating this disease. <h3>Case Description</h3> A 43-year-old woman with no significant medical history presented with a 10-year history of urticaria within minutes of sunlight exposure. She avoided being outdoors, but developed urticaria even with minimal exposure, such as sitting near a window. She denied any other triggers or associated angioedema. She trialed first- and second-generation antihistamines and montelukast, with minimal effect. Antihistamine use was limited by sedation, which was unacceptable given her work as a radiologist. She initiated omalizumab 300 mg by subcutaneous injection every 28 days. By the third dose, she experienced near complete remission. She could spend upwards of 1 hour in sunlight, with few or no hives. She reported a marked improvement in quality of life, being able to exercise outdoors and engage in social activities. <h3>Discussion</h3> The decision to use omalizumab was informed by the intolerable side effects of antihistamines and the inability to fully avoid sunlight. Her near complete response to omalizumab is notable, as most patients reported in the current literature only experienced a partial response with omalizumab, even at high doses. Omalizumab may be considered for patients with solar urticaria unable to use antihistamines, or with a low threshold for developing lesions. Importantly, omalizumab therapy may help in improving quality of life given the substantial burden of this disease.