Foodborne illnesses colloquially referred to as “food poisoning” are a major global health concern. These diseases lead to nearly half a million deaths worldwide on a yearly basis and often can be preventable. Clinical presentations can include rapid onset illnesses and more prolonged and delayed presentations. Gastrointestinal symptoms often predominate with other symptoms depending on the responsible microorganism. Implicated foods include shellfish, fish, and other foods such as raw milk or egg. Treatment is often supportive, and the diagnosis is often made clinically. A significant overlap of symptoms and clinical presentations can occur with food allergy, and the clinical history is critical to differentiate between the two disorders. Similarities between food allergy and foodborne illness may include the type of food, timing of presentation, prior reaction history, and presence of symptoms in fellow diners. Knowledge of the patterns, epidemiology, etiology, and presentations of foodborne illness will help the practicing allergist differentiate between these two common health concerns.