The inability to accurately predict the severity of future allergic reactions to foods in a given individual coupled with the real--although usually remote--risk of a fatal anaphylactic reaction complicates care and remains a constant source of concern to food-allergic patients, their family members, and health care providers. Current epidemiologic evidence suggests that the incidence of food-induced anaphylaxis is increasing, although confidently approximating the incidence of fatal allergic reactions to foods remains difficult. This article briefly reviews the epidemiology of fatal anaphylactic reactions to foods, discusses factors that may aid in identifying individuals at higher risk, emphasizes important aspects of patient education and prevention, and touches on the psychological impact of having a family member with food allergy.