Leukotrienes are potent proinflammatory mediators derived from of arachidonic acid through the 5- lipoxygenase pathway. Experimental data suggest a role for cysteinyl leukotrienes in the pathogenesis of atopic dermatitis and there is a rationale for the use of pharmacological agents to antagonize their effects in the treatment of atopic dermatitis. We report 2 cases of severe atopic dermatitis successfully treated with montelukast as a single therapeutic agent in a daily dose of 10 mg for 8 weeks when corticosteroid treatment was contraindicated or failed to control the disease. Our observations suggest that montelukast may be used as an alternative steroid sparing medication for severe atopic dermatitis, especially in patients with associated asthma and rhinitis.