Food allergies are increasing in incidence, and the variety of triggering antigens is widening. There is also an increased recognition of the breadth of immunologically mediated responses to dietary antigens; the area of non-IgE-mediated food allergy is belatedly acquiring scientific respectability, aided by improved clinical recognition and basic scientific studies. The role of mucosal mast cells and eosinophils in intestinal allergic responses is now better recognized, and conditions such as eosinophilic oesophagitis are more prevalent than previously thought. However, the diagnostic difficulties of non-IgE-mediated allergies remain challenging.