BACKGROUND Since raw egg may cause digestive toxic infections, we assessed whether pasteurized raw egg white is as reliable as fresh raw egg white in the diagnosis of egg allergy. METHODS Thirty-two egg-allergic children were challenged with both pasteurized and fresh raw egg white. Open challenges were carried out with increasing doses of pasteurized raw egg white and fresh raw egg white administered every 60 min. RESULTS Eleven children (34.4%) had positive challenges with pasteurized raw egg white. Twenty-one children (65.62%) who tolerated pasteurized raw egg white also had a negative challenge with fresh raw egg white. If the challenge with pasteurized raw egg white resulted positive, the study was stopped. The protein profile and IgE-binding capacity of both pasteurized and fresh egg white were almost identical as observed by SDS-PAGE and IgE immunoblotting. In the IgE immunoblotting-inhibition and ImmunoCAP-inhibition assays, both extracts behaved in a similar way. CONCLUSIONS We did not find any relevant allergenic differences between fresh and pasteurized egg white. This study supports the use of pasteurized egg white in the diagnosis of allergy to fresh raw egg proteins.