Objective To analyze and summarize the clinical manifestation of buckwheat allergy in children in order to increase the awareness and diagnosis of buckwheat allergy in children. Methods Children with buckwheat allergy were enrolled from outpatients in the Department of Allergy, Children’s Hospital of Capital Institute of Pediatrics during July 2019 through April 2022. Clinical data was collected, including skin prick test (SPT), serum allergen specific immunoglobin E(IgE) and peripheral eosinophil detection. Results A total of 23 cases (14 males and 9 females) were enrolled, with a median age of 7.8 (5.5-10) years. The children developed allergic symptoms after intake of buckwheat products, skin exposure of buckwheat or inhalation of buckwheat flour. Allergic symptoms occurred within 10 minutes in sixteen cases, within 10 minutes to 30 minutes in twenty-two cases, and within 30 minutes to 2 hours in six cases after exposure to buckwheat allergen. The most common clinical manifestations were skin symptom (21/23 cases, 91.3%), followed by respiratory symptom (15/23 cases, 65.2%), digestive symptom (5/23 cases, 21.7%) and neurological symptom (1/21 cases, 4.3%). 16 cases had severe anaphylaxis. 21 cases were tested positive in buckwheat SPT, and the risk of anaphylaxis was increased when the SPT level was “++++” (P<0.01). The detection level of serum total IgE in 23 cases was 120 to 1489 kU/L. All the cases had a history of allergic rhinitis, eczema and family allergies. 18 of them have diagnosed with bronchial asthma. 22 of them had a history of using buckwheat husk pillows. Conclusions Buckwheat allergy in children has lately onset in school-aged children and adolescent, with varied clinical manifestations and high rate of anaphylaxis. Buckwheat husk pillows may be an important way for buckwheat sensitization. Skin prick test is of great value in the diagnosis and evaluation of buckwheat allergy.