In contrast to IgE-mediated food allergies, diagnosis of the various non-IgE mediated food allergy syndromes can be challenging due to the overall lack of noninvasive confirmatory testing for these disorders. Many of the non-IgE food allergy syndromes are are diagnosed clinically, based on history and managed empirically with food avoidance. Therefore, it is essential for the practicing allergist to be familiar with the myriad presentations of non-IgE mediated food allergy. This review focuses on the presentation and management of the non-IgE mediated food allergy syndromes.