The present study assessed whether serum carotenoids and tocopherols are associated with atopic diseases (eczema and asthma) in 10- and 13-yr-olds in a Japanese community. Of 2796 students attending schools in Shunan, Japan, in 2006, 396 students were randomly selected for this study using nested case-control design. Atopic diseases and dietary food intake were assessed using self-administered questionnaires, and serum antioxidants were analyzed using high-performance liquid chromatography. We found no associations between serum carotenoids and atopic diseases. However, odds ratios (OR)s for the third and fourth quartiles of serum alpha-tocopherol with atopic eczema were 0.33 (95% confidence interval: 0.15-0.73) and 0.36 (0.14-0.89), respectively, and the trend was negatively significant (P(trend) = 0.048). We did not find a significant association for asthma. In conclusion, serum alpha-tocopherol was negatively associated with the prevalence of eczema. Serum carotenoids did not show definitive protective effects in Japanese youth.