Background and objectives. Zinc deficiency increases risk of infections, allergies and autoimmunity. We wished to determine risk factors in severe atopic dermatitis (AD) and identifi ofhypozincemia rate. Materials and methods. Retrospective study done on AD children (<= 14 years) with serum zinc test. Data included demographic and laboratory tests (serum zinc level IgE, food-specific IgE), and skin tests. Results. 168 AD children, aged 38.9 months with concomitant allergies in 47 (28%), family history ofallergies in 131 (80%), and parental consanguinity in 134 (79.9%). AD was mild in 12 (72%, SCORAD 15.8) children, moderate in 41(24.5%, SCORAD 30.4), and severe in 115 (68.3%, SCORAD 69.4). Hypozincemia was observed in 42 (25%, zinc 8.6 +/- 1.1 mu moI/L) children and associated only with severe AD (p = 0.0418) and elevated IgE (p = 0.001). Conclusions. Hypozincemia is rather prevalent in AD, and severe AD and high IgE increase its risk. An adjunct oral zinc may help reducing severe poorly responsive AD.