BACKGROUND Food ladders (FLs) are increasingly utilised for the management of children with food allergy. We aimed to characterise the utilisation of FLs among ASCIA-affiliated healthcare professionals (HCPs) in Australia and New Zealand (NZ) focusing on cow’s milk, egg, soy and wheat allergies. METHODS A quantitative survey approach was employed using a structured questionnaire comprising 20 questions. Measures included demographics, indications for FL usage, timing strategies for reintroduction when ladder steps are not tolerated and scenario-based decision-making. Descriptive statistical analysis explored similarities and differences in practice among respondents. RESULTS Seventy respondents participated in the study, comprising doctors (72%), nurses/nurse practitioners (14%) and dietitians (14%). A mixture of public and private HCPs were represented, primarily involved in paediatric care (93%). Seventy-one percent of respondents utilised food ladders for both non-IgE and IgE-mediated allergies, employing diverse strategies such as providing recipes (65%) or home food introduction protocols (68%). FLs were frequently recommended in patients with non-anaphylactic IgE-mediated allergy (67% for milk and 79% for egg) and much less so in patients assessed as having had an episode of anaphylaxis (13% for milk and 19% for egg). CONCLUSION Our study highlights widespread adoption of FLs among ASCIA-affiliated professionals for managing food-allergic children. Substantial variability exists as to implementation practices, the largest differentiating factor in our cohort being based on history of allergy severity. Further research into indications for FL usage, optimal timing of commencement and other pragmatics of implementation is warranted.