Background: Allergic diseases are a major public health challenge for children. To date, a comprehensive assessment of the disease burden of major allergic diseases in Chinese children is still limited. Objective: This study aimed to analyze the epidemiological characteristics of major allergic diseases in China through the Global Burden of Disease Study 2021 (GBD 2021). Methods: The incidence and prevalence of asthma, atopic dermatitis (AD), and urticaria among children aged 0 to 14 years in China from 1990 to 2021 were assessed through data from GBD 2021. Moreover, subgroup analyses by sex, age, and China/global comparisons were performed to analyze the differences more accurately. We used Joinpoint regression analyses to quantify temporal trends, calculate annual percentage changes, and average annual percentage changes. Results: From 1990 to 2021, China experienced significant declining trends in childhood asthma, with incidence and prevalence falling by approximately −26% and −23%, respectively. These rates were consistently higher in boys (male-to-female ratio >1.3). In contrast, AD presented a mixed pattern: a slight decrease in incidence (−6.7%) alongside a marginal rise in prevalence (+1.5%), diverging from the global decline. AD showed a consistent female predominance. Meanwhile, urticaria remained relatively stable nationally (incidence: −2.3%, prevalence: −0.4%), but exhibited a pronounced female skew, with incidence and prevalence rates about 60% higher in girls. Conclusion: Although the burden of asthma has decreased, the prevalence of AD has been increasing, whereas the prevalence trend of urticaria has been relatively stable. The burden of allergic diseases is still large, and there are obvious sex differences.
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