Cow’s milk allergy is common in children and rare in adults. The clinical features of cow’s milk allergy are varied and they include anaphylaxis, gastrointestinal symptoms and atopic dermatitis. The prevalence of cow’s milk allergy is difficult to ascertain, based on self-reported symptoms that are not subsequently confirmed by diagnostic testing. The gold-standard diagnostic test is the double-blind placebo-controlled food challenge. Avoidance of milk and milk products is the main therapy. Nutritional considerations are important in both children and adults, as is recognising the potential for resolution of cow’s milk allergy. Providing evidence-based advice and support to individuals and their families and carers is central to managing cow’s milk allergy.