Introduction: Seasonal allergic rhinitis (SAR) is typically characterized by rhinorrhea, nasal congestion, sneezing, and itching of the nose, eyes, ears, and pharynx. Aim: To evaluate the natural course of the disease in patients diagnosed with SAR. Material and methods: The study included 191 patients diagnosed with SAR before January 2009 and who were followed up in our clinic. A survey was applied to these 191 between June 2019 and June 2020. Patients were asked to compare their initial symptoms and symptoms in the last year. Results: The median age of the 191 patients in this study was 35 (range: 22-70 years) and median SAR duration was 15 (range: 10-40 years). The most common disease accompanying SAR was asthma (n = 93, 48.7%). The most common sensitizing allergen was Phleum pratense (n = 180, 94.2%) and the most common symptoms were nasal discharge (n = 178, 93.2%), nasal itching (n = 176, 92.1%), sneezing (n = 182, 95.3%), ocular itching (n = 136, 71.2%) and ocular discharge (n = 129, 67.5%). Over the past year, nasal symptoms increased in 49 (25.7%) patients, decreased in 78 (40.8%) and did not change in 64 (33.5%). Ocular symptoms increased in 26 (18.7%) patients, decreased in 65 (46.7%) and did not change in 48 (34.5%). Nasal symptoms decreased in patients who applied pollen avoidance strategies (p = 0.008). Conclusions: The natural course of SAR in long-term follow-up is variable. The implementation of effective pollen avoidance measures can reduce the disease severity in patients with SAR in the long term.