Background Anaphylaxis is a severe allergic reaction with diverse clinical presentations. Identifying symptom patterns based on allergen molecules and age could improve diagnosis and management. This study assessed anaphylaxis manifestations in children, focusing on the impact of allergen molecules and age on symptom distribution. Methods A retrospective analysis was conducted on 185 pediatric patients (0–18 years) hospitalized for anaphylaxis between 2020 and 2024. Molecular allergen-specific IgE profiles were determined using the ALEX 2 test. Symptom frequencies across different organ systems were analyzed in relation to allergen molecules and age groups. Statistical analyses included Cochran’s Q test and Pearson’s χ 2 test with post-hoc adjustments. Results The most frequent molecular triggers were Ara h 2 (18.79%), Gal d 1 (9.09%), and Ana o 3 (9.09%). Significant differences in symptom distribution were observed within individual allergen molecules (p < 0.05), but no molecule-specific symptom pattern was identified. Age influenced respiratory symptom prevalence, with significant differences between infants and older children (p = 0.003). For the gastrointestinal system, results suggest the potential presence of differences that may not be detectable due to sample size limitations (p=0.051). Cardiovascular symptom differences by allergen type and age were suggested but not statistically confirmed. Conclusions Anaphylaxis symptom profiles vary across organ systems but do not show clear molecule-specific patterns. However, age-related differences in respiratory symptoms suggest that age is a relevant factor in anaphylaxis presentation. Larger studies are needed to confirm potential associations between allergen molecules, age, and symptom distribution.