Background <p>Pitaya, commonly known as dragon fruit, is increasingly available and has allergenic potential. Pollens have been found to have cross-reactivity and thus induce allergies to several fruits, however, to our knowledge this is first report of pitaya anaphylaxis in a patient without co-sensitization to other fruit or environmental allergens.</p> Case presentation <p>A 26-year-old male presented to the emergency department with anaphylaxis after consumption of pitaya (dragon fruit). He had no prior history of atopy. Epicutaneous skin testing demonstrated positive to pitaya and negative to all other cross-reactive food and environmental allergens, suggesting his pitaya allergy did not derive from cross-sensitization.</p> Conclusions <p>Our case is unique in demonstrating the potential for pitaya allergy to occur independent of other allergies and cross-sensitization. Future research is warranted into suspected allergenic proteins in pitaya and quantifying their structural similarity to other known allergens.</p>