Paracetamol (acetaminophen) is widely used and considered safe, since adverse reactions to this drug in therapeutic doses are rare, especially in children.1,2 Only a few cases worldwide of anaphylaxis to paracetamol in children have previously been described.2-11 Anaphylaxis is defined as a life-threatening reaction resulting from mast cell derived mediator release.12 This report illustrates a case of anaphylaxis to oral paracetamol confirmed by an oral provocation test and an increase in serum tryptase level.