Food allergy has increased in developed countries over the past 20 years and it has been estimated that food allergic reactions affect some 6∼8% of children. Food allergy is common and potentially serious problem in childhood. Adverse reaction to food could be classified into four groups: IgE-mediated food allergy; non-IgE mediated food allergy; non-allergic food hypersensitivity; and symptoms falsely assumed to be due to foods. Allergic testing is moving towards established thresholds levels of specific IgE that predict a probability of a clinical reaction and reduce the need of oral food challenge. Diagnosing and managing food allergy in children largely depends upon a thorough medical history with questions targeted to differentiate the character of the reaction for each suspected food. Investigations such as skin prick testing and specific IgE are helpful only in IgE-mediated reactions. The mainstay of management is to avoid the offending allergen. An anaphylactic reaction is an indication for self-injectable epinephrine for emergency use. Studies of allergen characterization and immunologic mechanisms are needed and should provide a better understanding of the immunopathology of food allergy and new, more specific forms of diagnosis and therapy. It is important to identify children with potentially life-threatening food allergy as life-threatening reaction can occur. A clear understanding of the manifestations of food allergy caused by both IgE- and non-IgE-related mechanisms will help the practitioner to identify children who likely have food allergy so that additional diagnostic evaluation can be performed and appropriate avoidance can be instituted.