Ginseng is a perennial herb used in traditional Chinese medicine, which has become increasingly popular world-wide due to its proposed medicinal effects, including improved cerebral function, glycemic control, pain relief, stress reduction, and many others [
1‐
3]. There are two major species of ginseng,
Panax ginseng (Korean or Asian ginseng), and
Panax quinquefolius (American ginseng) [
1]. Approximately 40 active ingredients have been identified in ginseng, but the pharmacological properties are attributed to their triterpene glycosides, also known as saponins or ginsenosides [
3]. American and Korean ginseng have distinctive distributions of ginsenosides, which are thought to account for their differing proposed medicinal effects [
3]. Cases of anaphylaxis, occupational asthma and allergic rhinoconjunctivitis due to Korean ginseng have been reported in Korean adults [
4‐
8]. In contrast, there are no reported cases of allergy against American ginseng, or reported cases of ginseng allergy in pediatric patients. We present two unique cases of pediatric patients presenting with suspected allergy to American ginseng.