Objective: To assess the frequency of atopy (specific IgE levels), to evaluate the allergic symptoms using the Allergy Questionnaire for Athletes (AQUA), and to determine whether atopy is associated with allergic symptoms in elite endurance athletes. Design: Cross-sectional study. Setting: Assessments were performed at Hospital das Clinicas—São Paulo University Medical School. Participants: Fifty-nine elite endurance athletes (triathletes and runners). Main Outcome Measures: Allergic symptoms were assessed by a validated self-report AQUA questionnaire and atopy by specific IgE level. Results: The frequency of atopy (specific IgE to at least one inhalant allergen) and allergic symptoms was 57.6% and 54.2%, respectively. In addition, no association was observed between atopy and allergic symptoms. Conclusions: A possible implication from our results is that atopy screening in elite athletes should be performed using AQUA questionnaire and measuring specific IgE simultaneously.