Introduction Food allergies (FA) are a significant health concern for children in the United States, yet access to proper diagnosis and management can be limited. This study aims to characterize current childhood FA diagnosis practices in the US. Methods A survey was administered via web and telephone to a sample of US households between 2015-2016, providing parent parent-proxy responses for 41,341 children. Stringent symptom criteria were developed with FA experts to distinguish respondents with “convincing” FA from those with similar conditions. Post stratification-weighted proportions were estimated to compare FA diagnosis characteristics by allergy type. Results Approximately 39% (95% CI: 35.6-42.4) of convincing FA was not physician diagnosed. For families earning between $25,000 and $50,000, children were significantly more likely to not have received a physician diagnosis. Among physician-diagnosed FA, 68.2% (95% CI: 63.6-72.4) were evaluated with a skin prick test, 50% (95% CI: 46.2-54.7) with an IgE test, and 25% (95% CI: 21.2-29.3) with an oral food challenge. Rates of physician diagnosis differed by allergen with 81% of convincing peanut allergies physician diagnosed compared to under 55% of convincing milk, fin fish, wheat, and soy allergies. Odds of physician diagnosis were significantly higher for children with eczema, asthma, and seasonal allergy. Conclusions These data suggest that children with convincing FA are often not receiving a proper diagnosis. It is critical we determine barriers to physician diagnosis of FA to ensure the best care and management of these children.