There is a widespread trend of increasing the incidence of anaphylaxis among children. Children suffering from anaphylaxis represent a complex and ambiguous group of patients. The factors that cause difficulties in diagnosing anaphylaxis in children are: a wide range of triggers; unpredictability of the nature, severity of clinical symptoms of systemic reactions and their age-dependent interpretation. The first anaphylactic reaction always stuns parents and medical staff, which leads to a subjective description of the anamnesis and a delay in making a diagnosis and prescribing the correct treatment. For this group of patients, such problems as the lack of available diagnostic tests for verifying the diagnosis of anaphylaxis, the restriction of standard doses of epinephrine autoinjectors, the lack of predictors of the occurrence and severity of systemic allergic reactions continue to be relevant. The article is devoted to the most urgent difficulties and features of managing patients with anaphylaxis in pediatric practice and discussing possible prospects and ways to solve them.