The aims of this case-control study were to determine the prevalence of Anisakis-specific IgE in patients reporting chronic or acute gastrointestinal (GI) symptoms and to investigate the correlation with raw fish ingestion habits. A group of patients undergoing gastric endoscopy and a control group of healty subjects answered a self-administered questionnaire on their food habits, presence of symptoms (both allergic and not allergic), and general life style. The presence of anti-Anisakis IgE has been evaluated using a serum immunoCAP assay. Our data show a low prevalence of IgE directed against Anisakis allergens in Italy in dyspeptic patients, despite the high consumption of poorly cooked fish. These findings does not correlate with the results of studies from other Mediterranean countries, such as Spain, for example. The general prevalence of Anisakis allergens sensitization in Italy could be further investigated through screenings in the allergic population, especially on those patients who claim to have developed a fish allergy and with history of raw fish consumption. Moreover, the attention should be moved on recent allergic reactions associated with fishing ingestion. This could in fact indicate a recent encounter with the parasite. Finally, we must underline that the evaluation of Anisakis-specific IgG would have probably shown a difference in terms of exposure between the two groups; thus, it might be useful to detect also this antibody class in future population-based studies.