BACKGROUND: Cashew (Anacardium) is a tree nut allergen which can induce severe symptoms, including anaphylaxis. However, only a few cases of tree nut allergies have been reported in Korea and Japan. We experienced a case of cashew allergy. CASE HISTORY: A-27-year-old female patient presented with facial urticaria, lip edema, conjunctiva injection, nausea, vomiting, and voice change after eating cashew. The patient suffered from recurrent symptoms after eating food containing cashew. RESULTS: We measured specific immunoglobulin E (IgE) to various tree nuts in serum using the Pharmacia CAP system and confirmed a marked increase of serum specific IgE to cashew and pistachio. However, allergic reactions occurred only after ingestion of cashew. CONCLUSION: We report a case of cashew allergy confirmed by the typical clinical history and specific IgE test.