To identify the risk factors of oral food challenge (OFC) -associated anaphylaxis, we performed retrospective analysis of OFCs performed at our hospital between 2005 and 2018. Anaphylaxis occurred in 347 of 9230 patients who underwent OFC. The prevalence of anaphylaxis tended to decrease year by year. The most common food tested by OFC was egg, followed by milk and wheat, and their respective prevalences of anaphylaxis were 3.9%, 6.2% and 6.0%. A short interval between doses, i.e., 15 minutes or less, was most common in the earlier period (up to and including 2012). A longer interval, i.e., more than 30 min, was most common in the later period (after 2012). On the other hand, specific IgE-antibody titers to egg, ovomucoid and milk were significantly higher in the later period than in the earliest period, 2005-2007. In conclusion, the prevalence of OFC-associated anaphylaxis decreased dramatically in recent years, probably due to the longer interval between doses and use of smaller test doses. Meanwhile, more OFCs were performed for patients with high specific IgE titers in recent years than before, hoping to determine the maximum dose at which complete elimination diet would not be necessary. Further investigation is necessary to establish the parameters for safe performance of OFC.