Introduction: Anaphylaxis is a potentially life threatening allergic reaction that is rapid in onset and multisystemic in nature. Distribution of anaphylaxis tends to fluctuate based on age, gender, race, geographical residence and socioeconomic status of the involved subjects. Diagnosis of anaphylaxis in children is generally underestimated particularly in developing countries, and when diagnosed, proper management is occasionally lacking. Aim of the study: to evaluate the frequency and pattern of anaphylaxis and mistakes in diagnosis and treatment among a group of Egyptian children and adolescents. Subjects and methods: This observational study was conducted over 6 months duration, from 1st of September 2019 to the end of February 2020, in Children’s hospital, Ain Shams University, Cairo, Egypt, on children presenting to emergency department (ED). Anaphylaxis frequency, presentation, triggers, diagnosis, management and long term follow up were assessed. Results: frequency rate of anaphylaxis among children and adolescents was 0.43% (80/18816) over a year. Sixty percent of patients were infants. Biphasic reactions were reported in 11.3% of patients. The commonest trigger was food (22.5%) followed by medications (8.8%). Epinephrine was given to all patients, in proper dosage and method in most occasions (78.7%). Long term management and follow up appointment were deficient. In conclusion: Anaphylaxis in children was relatively high, with food being the most common trigger. Diagnosis and early management of anaphylaxis was satisfactory, however, long term management and follow up were defective.