Mammalian meat allergy (MMA), or alpha-gal syndrome, is an increasingly recognised condition in Australia, first described in 2007. Sensitisation follows bites from Ixodes holocyclus, inducing IgE antibodies to galactose-α-1,3-galactose (alpha-gal), an oligosaccharide found in non-primate mammals. Australia now reports the highest global incidence, with estimates of 113 cases per 100,000 in the Sydney Basin. Unlike classical food allergy, MMA causes delayed (2–10 hour) and unpredictable reactions, progressive loss of tolerance to mammalian products, and decreasing elicitation thresholds over time. Symptoms range from urticaria and angioedema to dysphonia, airway oedema, and life-threatening anaphylaxis.For otolaryngologists, MMA presents specific perioperative risks. Many routine surgical materials, pharmaceuticals, and biologics contain bovine or porcine tissue and may trigger severe reactions in sensitised patients. High-risk agents include catgut sutures, Gelfoam, thrombin-based haemostats, Avitene, Tachosil, and heparin derivatives. Cetuximab, used in head and neck oncology, is a well-documented cause of alpha-gal anaphylaxis. Safer alternatives include Surgicel, tranexamic acid, Tisseel, and synthetic products such as Nasopore.This poster summarises the common ENT-relevant triggers for allergic reactions in MMA and provides practical alternative product recommendations. Recognition is essential both in planned procedures and when assessing unexplained intra- or postoperative anaphylaxis, airway compromise, or delayed allergic symptoms. Early referral for alpha-gal-specific IgE testing and a history of tick exposure are key components of assessment.Improved awareness of MMA in ENT practice will reduce preventable perioperative reactions, support safer procedural planning, and improve outcomes for an expanding at-risk patient population.