RATIONALE: Gender differences have been reported in household costs in living with food allergy, however, to date no validated disease specific questionnaire has been available to measure direct, indirect costs. AIM: To measure gender differences in the direct, indirect, and socio-emotional costs of living and seeking healthcare for adults with (cases) and without (controls) food-sensitivity. METHODS: We used the validated ‘household costs of food allergy’ questionnaire in a clinical case-control study design in four countries (Spain, Netherlands, Poland, UK). Uniform cluster analysis was applied to the data set using a two-step approach with regard to direct, indirect and social-emotional costs. Analysis of covariance with post-hoc tests were used to identify significant differences between genders on individual variables. RESULTS: Three clusters emerged from the analysis. The overall mean for direct costs was 5491.0 per annum. Cluster 1 was above mean (M 7198.3, SD 5433.2); Cluster 2 was at mean (M 5547.1, SD 2917.5) and Cluster 3 fell below mean (M 4585.7, SD 2990.4). The biggest single percentage of cases (male 40% female 60%) fell into Cluster 1. The largest single percentage of controls male (100%) and female (100%) were identified within Clusters 2 and 3, respectively. The pattern for indirect and socio- emotional costs showed similar gender differences. CONCLUSION: Food allergy confers a significant socio-economic burden, particularly on females. This is the first time that a validated socio-economic measure has become available and will be invaluable for regulators and policy makers in both the evaluation of present and future interventions and the effective targeting of resources.