Oral food challenges are essential in diagnosing food allergies correctly. However, the decision to proceed to oral food challenge is complex and influenced by different factors. The procedures have to be conducted by allergy specialized centers and require careful preparation. Besides being performed double-blind and placebo-controlled the blinding of the food is challenging and limited by the amount and type of food. The interpretation of the results of the challenge are important. Not only the positive but also the negative results have to be discussed with the patients. Dietary implications of food avoid-ance and re-introduction should be provided desirably by a dietician.