Health-related quality of life (HRQL) is frequently used as an outcome criterion to evaluate the quality and effect of different therapies. However, little is known about the HRQL of the general population, the prevalence of specific HRQL problems and about which factors have an impact on HRQL assessments. To examine children's HRQL from their own and their parents' perspectives. The study sample consisted of children attending the third and fourth grades of elementary school in the capital of Austria, Europe. One thousand four hundred twelve children and 1185 parents completed child- and parent-versions of the Pediatric Quality of Life Inventorytrade mark (PedsQLtrade mark). In addition to the PedsQL questions, children and parents were asked a number of questions with regard to sociodemographic information and specific problems that were hypothesized to be associated with the children's HRQL. Altogether, the children demonstrated a good HRQL and their PedsQL scores were similar to those of children from other developed countries. About 15% of children showed a notably low HRQL, and two-thirds of these children were from financially less privileged families. Multivariate regression analyses identified the following factors associated with the children's HRQL: the family's perceived financial situation, parents' quality of life, children's school performance, medical and/or psychologic problems (eg, dyslexia, recurrent stomachache or headaches), chronic disease, a recent life-event (eg, divorce/separation of parents), and parents' satisfaction with school. Assessing children's HRQL may be helpful to take preventive action and to identify those who are in urgent need of special services.