Introduction: An increased prevalence of coconut allergy has been reported among children with food allergy in Sri Lanka, which is a significant concern given the extensive use of coconut in Sri Lankan cuisine. Objective: The objective of this study was to characterize the spectrum of allergic reactions to coconut from a Sri Lankan cohort. Methods: 14 children who had a history of coconut allergy , referred to our allergy clinic, were recruited to the study . Sociodemographic data and relevant clinical data were gathered via using an interviewer-administered questionnaire. Skin prick testing (SPT) and coconut-specific IgE (ImmunoCAP) were performed as diagnostic tests. Results: 7/14 children were females, and the median age of the cohort was 5 years (IQR: 6 months–18 years). The allergy began with the first introduction of coconut during weaning, with immediate symptom onset (< 30 minutes). All patients had urticaria, 71.43% had itching and angioedema, 35.71% had vomiting, 42.85% had swelling of lips, 21.42% had dizziness, difficulty in breathing, 14.29% had abdominal pain, diarrhea, and loss of consciousness. 5/14 children had a history of anaphylaxis with mild to moderate anaphylaxis after consuming coconut. 8/14 patients had severe atopic dermatitis, with an average severity score of 12/15 based on the SCORAD scale. All 14 patients had allergies to more than one food. Conclusion: Coconut allergy appears to present early with clinically significant immediate reactions, often in the context of severe atopic dermatitis and polysensitization to multiple foods.