Purpose: Prenatal maternal stress should be considered as a risk factor for the development of allergic disease in the offspring. However, only one recent birth cohort study showed an association between prenatal maternal stress and allergic rhinitis (AR) in the offspring. This study investigated the effect of prenatal maternal stress on AR development and its severity. Methods: 1,577 mother-childhood dyads were followed at 2015 from the Panel Study of Korean Children ( PSKC) study, since 2008. Maternal stress was evaluated by self-reported questionnaires by using Kessler Six-question Psychological Distress Scale (K6) during the last 30 days before delivery and 6 months after delivery. Mothers were asked to recount their psychological state during the last 30 pregnancy days retrospectively, completed immediately after delivery. Occurrence of AR at 7 year-old-age was evaluated by reporting of symptom during last 12 months, treatment during last 12 months, and diagnosis ever. Among 1,577 children, 642 children visited the 16 regional hospitals and were interviewed by a detailed history and physical examination. The association between prenatal maternal stress and AR was assessed by using logistic regression model. Results: Increase of prenatal maternal stress (K6 ≥13) significantly increased the offspring’s AR symptoms during the last 12 months [adjusted odds ratio (aOR) 1.36; 95% confidence interval (CI) 1.08-1.70]. After additional adjustment for postnatal maternal distress by K6, the associations remained significant (aOR 1.32, 95% CI 1.02-1.72). Prenatal maternal stress score was significantly elevated in moderate to severe and persistent AR by ARIA guideline. When we divided into four groups according to the prenatal maternal stress and children with AR, the group with prenatal maternal stress and children who have AR showed the highest level of serum eosinophil percentage, serum total IgE, and atopy rate, although which is not statistically significant. Conclusions: Prenatal maternal stress affects the development of AR and its severity from a birth cohort study. Reducing prenatal maternal stress may reduce AR occurrence in the offspring. Funding: This study was supported by a fund (2015ER6600100) from the Research of Korea Centers for Disease Control and Prevention.