BACKGROUND The relationship between an atopic diathesis and contact sensitization to fragrances is unclear. OBJECTIVE To investigate whether there is an association between atopy and allergy to fragrance mix I (FM I). METHODS The computerized files of patients patch tested to FM I at St John's Institute of Dermatology (1980-2004) were reviewed. Demographic details recorded for all patch-tested patients included age, sex, date of testing, history of current or previous atopic eczema (AE), history of current or previous asthma nor hay fever (A/HF), family history (FH) of any type of atopy, and any positive patch tests. RESULTS About 8.4% of females (1713/20 338) and 6.6% of males (903/13 734) were allergic to FM I. About 8.95% (101/1129) of females with AE were allergic to FM I versus 8.63% (619/7171) of females who had neither AE and A/HF nor FH (non-atopics) (P = 0.72). About 5.6% (40/710) of males with AE were positive to FM I versus 6.9% (427/6201) of male non-atopics (P = 0.23). There was a striking increase in AE and A/HF during this 25-year period (P < 0.0001). CONCLUSIONS We found no association between atopy and allergy to FM I. There has been a marked increase in atopy in individuals referred for patch testing in the past 25 years.