BACKGROUND False positive test results in children who are tested for food allergies may lead to inappropriate dietary restrictions. OBJECTIVE The aim of this study was to report our experience with a 3 year-old boy, who presented with "multiple food allergies" and, however, passed the food challenges, and to review our experience regarding management of children with high specific food IgEs with high total IgE. METHODS Medical records of 16 children with food challenges were reviewed. Median age of subjects was 39 months, with a history of adverse clinical reaction to a food, a specific IgE greater than the decision point, and an elevated total serum IgE level of 500 IU, underwent challenges to the offending food. RESULTS 13 out of 16 subjects were successfully re-exposed to the suspected foods and continued to tolerate these foods well. CONCLUSION Our finding suggests a much lower clinical risk with previously defined specific IgE decision points in children with very high levels of total IgE (> 6000 IU/ml).