Background: The prevalence of allergic sensitization has increased all over the world during last years and allergic sensitization may be related to genetic or environmental factors or to both. The objective of this study was to estimate the prevalence rates of allergic sensitization and assess the familial aggregation of allergic sensitization to aeroallergens in asthma index families. Methods: The skin prick test (SPT) reactivity to 8 aeroallergens and the SPT reactivity-related risk factors were evaluated. The allergic sensitization was based on SPT. Univariate and multivariate logistic regressive models were used to estimate the effect size (odds ratio, OR) of correlation within families with positive SPT. Results: Of 4,213 analyzed subjects in 1,006 asthma index families, 40.9% had at least one positive SPT, 42.3% in parents (father: 43.3%; mother: 42.3%), 43.9% in first offspring, and 36.0% in subsequent offspring. The most common allergens were Dermatophagoides pteronyssinus (DP), cockroach and Dermatophagoides farinae (DF). Allergic sensitization status of both parents and first offspring was related to the risk of allergic sensitization for subsequent offspring. The OR for the positive (father)-positive (first offspring) group was 1.92 (p < 0.01), 3.26 (p < 0.01) for the positive (mother)-positive (first offspring) group, and 2.12 (p < 0.01) for the positive (father)-positive (mother) group, which were adjusted for age, sex, body mass index, history of asthma and smoking status. Conclusions: Our findings supported a significant familial aggregation of allergic sensitization in this Chinese population and highlighted the role of genetic factors in allergic sensitization.