Eosinophilic esophagitis (EoE) is an antigen-triggered chronic disease of increasing prevalence in children and adults. Untreated or therapy-resistant EoE leads to complications of esophageal food impactions and luminal narrowing. The past decade has seen a number of new clinical trials for EoE therapies including elimination diets, proton pump inhibitors, swallowed topical corticosteroids, and biologics. In this review, we comment on the current state of the art for dietary and pharmacologic management of EoE and the need for future clinical trials to help tailor therapies to individual patients with this chronic disease.