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Background: Previous studies have used serum periostin levels as a biomarker of Th2-driven inflammatory responses. However, no population-based study has yet examined the association of serum periostin levels with the allergic status of children. Objectives: The aim of this study was to determine the usefulness of periostin as a biomarker for allergy in a group of 7-year-old Korean children. Method: This prospective cross-sectional study examined 451 children (aged 7 years to 7 years and 11 months) from the general pediatric population who attended 6 different schools between June and July 2016. A total of 249 children, all of whom completed the questionnaire and skin prick test and provided blood samples, were included in the final analysis. Results: The geometric mean serum periostin level was 107.6 ng/mL (95% CI 104.5–110.7). After adjustment for confounding, serum periostin levels were significantly associated with sensitization to poly-allergens (adjusted odds ratio, aOR 1.032, 95% CI 1.006–1.059, p = 0.016) and pollen (aOR 1.020, 95% CI 1.002–1.039, p = 0.026). Serum periostin levels were also associated with eosinophil levels (adjusted β = 0.023, SE = 0.009, p = 0.010), but were unrelated to body mass index, sex, obesity, or presence of an allergic disease. Conclusions: Our results suggest thatserum periostin level may have limited usefulness as a biomarker of allergic disease in children. [ABSTRACT FROM AUTHOR]