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Background/Objectives: Atopic dermatitis (AD) can be a debilitating skin condition, often leading to hospitalization due to severe AD exacerbations or infectious complications. As both AD exacerbations and infectious complications can present similarly, it can be difficult to distinguish the two conditions. Thus, we aimed to evaluate if there is any difference in serum IgE levels in children with AD who were hospitalized for AD exacerbation and for AD-associated infectious complications.Methods: A retrospective chart review was performed on hospitalized children with AD exacerbations and AD-associated infectious complications over a 17-year span.Data including length of stay, primary diagnosis, systemic antibiotics, laboratory, and bacterial culture results were collected. Serum total immunoglobulin E (IgE) levels were adjusted by age. Age, length of stay, total IgE levels, and age-adjusted IgE levels were compared using t-test. Logistic regression was used for age-adjusted IgE levels. Results:The mean serum total IgE level in subjects with AD exacerbation was 9603 ± 15,873 kU/L, which was significantly higher than that of subjects with infectious complications at 3167 ± 5486 kU/L (p = .029). Logistic regression revealed that subjects with an age-adjusted IgE of >4 had more than 3-fold odds of having AD exacerbation than infectious complications.Conclusions: Our results suggest that total IgE levels are higher in children who were hospitalized for AD exacerbation than those with AD-associated infectious complications.