A Major Pollen Surge Is Coming—These 20 US Cities Will Be Hit Hardest

If it feels like allergy season is starting earlier and getting stronger, you're not wrong. Clinicians and researchers have observed an earlier, longer, and more intense pollen season in many regions, influenced in part by climate and environmental shifts.

And unfortunately, another "pollen tsunami" is expected this year. Intense rainstorms, warmer temperatures, and drought have triggered more pollen spikes and longer pollen seasons, particularly in the West.

According to AccuWeather, tree pollen has already ramped up in parts of the South and West, and grass pollen is expected to spike later in spring and early summer. The Ohio Valley will be one of the hardest hit regions this year, with periods of exceptionally high tree pollen.

To help you prepare, the Asthma and Allergy Foundation of America’s (AAFA) Allergy Capitals report ranks the largest 100 cities in the contiguous U.S. by how challenging they are to live in when you have a pollen allergy. The rankings are determined by tree, grass, and weed pollen scores (aka how many days each city has high or very high pollen counts), over-the-counter allergy medicine use, and the availability of board-certified allergists and immunologists.

According to the 2026 report, here are the worst cities for managing seasonal pollen allergies.

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Top 20 Worst Places to Live With Pollen Allergies

1. Boise, Idaho
2. San Diego, Calif.
3. Tulsa, Okla.
4. Provo, Utah
5. Rochester, N.Y.
6. Wichita, Kan.
7. Raleigh, N.C.
8. Ogden, Utah
9. Spokane, Wash.
10. Greenville, S.C.
11. San Francisco, Calif.
12. Minneapolis, Minn.
13. Salt Lake City, Utah
14. Richmond, Va.
15. Colorado Springs, Colo.
16. Little Rock, Ark.
17. Toledo, Ohio
18. New Orleans, La.
19. Winston-Salem, N.C.
20. Lakeland, Fla.