Introduction: Sesame allergy has been seen with increasing frequency in recent years and is one of the important causes of food anaphylaxis. The aim of our study was to examine the clinical and laboratory features of patients with sesame allergy and to evaluate the characteristics of sesame-related anaphylaxis. Methods: Patients diagnosed with sesame allergy at Ankara Bilkent City Hospital between January 2017 and June 2024 were included in the study. Demographic, clinical, and laboratory data of the patients were obtained from medical records. Results: Sesame allergies were detected in 70 patients during the study period. Of these patients, 44 (62.9%) were male, and the median age at the onset of symptoms was 12 (interquartile range [IQR]: 9–18) months. Thirty-two patients presented with anaphylaxis (45.7%), 31 with urticaria/angioedema (44.3%), and 7 with atopic dermatitis (10%). A total of 59 patients (84.3%) had other food allergies. The most common food allergy was tree nut allergy (54.3%). Sesame-specific IgE levels were higher in patients with anaphylaxis (median 2.8 kU/L IQR: 1.2–17.8) than in those who did not (median 1.6 kU/L IQR: 0.7–4.7). In the multivariate logistic regression model, the presence of a concomitant food allergy (odds ratio: 18.7; CI 1.9–182.6) and being over 1 year of age at the time of the index reaction (odds ratio: 4.1; CI 1.1–15.4) were identified as risk factors for anaphylaxis. Conclusion: Sesame allergy is among the important causes of food allergy and anaphylaxis and generally presents with early-type reactions. It can be seen together with nut and other food allergies.

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