Chronic urticaria is characterized by recurrent hives, with or without angioedema, persisting for 6 weeks or longer. Although often suspected by patients, in fact specific allergen triggers are infrequent. In contrast, the condition may be associated with autoimmune and thyroid disorders. While some evidence suggests an association of chronic urticaria with vitamin D levels, measurement of vitamin D or supplementation is not a part of diagnostic or treatment recommendations. Chronic urticaria affects approximately 1% of the population and is often a spontaneous phenomenon without a clearly identified allergen trigger. Treatments involve non-sedating antihistamines in escalating off-label doses, omalizumab, anti-inflammatory medications such as hydroxychloroquine, and, in some patients, immunosuppressants such as cyclosporine. We report a case of a 14-year-old white boy with refractory chronic autoimmune vitamin D-responsive urticaria.