BackgroundUpdated epidemiological data are important for defining effective public health strategies for paediatric food allergy (FA). ObjectiveThe Epidemiology of Paediatric Italian Food Allergy(EPIFA) study was designed to investigate the epidemiology of paediatric FA in one of the most populated Italian region. MethodsRetrospective cohort study performed in collaboration with family paediatricians(FPs) aimed at the investigation of epidemiology of Italian paediatric FA in the years 2009-2021. FPs of the Campania Region were invited to use the Google Forms platform for the online compilation of the data forms. Data forms were reviewed by experienced paediatric allergists at the coordinating centre. ResultsA total population of 105.151 subjects (aged 0-14 years) was screened during the study period. Data from 752 FA patients were evaluated. A progressive increase in FA incidence and prevalence was observed from 2009 to 2021 with a relative increase up to 34% and 113.6%, respectively at the end of study period. The relative increase in FA prevalence was higher in the 0-3 years old age group in the same study period (+120.8%). The most frequent allergens were cow’s milk, hen’s egg, and nuts. ConclusionThe results of the EPIFA study showed an increase in paediatric FA incidence and prevalence from 2009 to 2021 in Italy. These results underline the necessity of new effective strategies for the prevention and management of these conditions.