Background: Shellfish is a common dietary component in coastal Bengal. However, shellfish allergy, a form of IgE-mediated Type I hypersensitivity reaction, is increasingly recognized as a health concern. This study investigates the prevalence of shellfish consumption, prevalence of shellfish allergy, associated risk factors, and clinical management among patients in a tertiary care hospital in Haldia, West Bengal. Methods: A cross-sectional observational study was conducted on 36 patients attending the tertiary care hospital. Data regarding shellfish consumption, allergic reactions, demographic profile, risk factors, and management were collected using structured questionnaires and medical records. Statistical analysis included calculation of prevalence, odds ratio (OR), and association between risk factors and shellfish allergy. Results: The prevalence of shellfish consumption was 77.7% (28/36). The prevalence of shellfish allergy among consumers was 21.4% (6/28). Major clinical manifestations included urticaria (50%), angioedema (33.3%), and anaphylaxis (16.7%). Significant risk factors included family history of allergy (OR = 3.2), asthma (OR = 2.8), and atopic dermatitis (OR = 2.5). Management primarily consisted of antihistamines (100%), corticosteroids (66.7%), and adrenaline for severe cases (16.7%). Conclusion: Shellfish allergy is an important health concern in coastal West Bengal. Early recognition of risk factors, public awareness, and prompt clinical management are essential to reduce morbidity.