Food allergy is a common cause of anaphylaxis, and its incidence is rising. The development of allergy is multifactorial, and the mechanisms of tolerance are complex. The natural history of food allergy varies by causative food; some allergies are mostly outgrown, while others are usually life-long. Anaphylaxis caused by food allergy may differ clinically from other causes of anaphylaxis. Death is usually caused by respiratory failure, and patients who have asthma are at greatest risk for severe reactions. At this time, avoiding allergenic triggers, and when that fails, timely administration of epinephrine, are the main approaches to food allergy. Although several experimental medications promise to dramatically change the field of food allergy, none of these treatments are currently available outside of research settings.