This study was conducted to examine the influence of medical, psychological, and familial factors on the coping of pediatric cancer patients. Participants were 36 pediatric cancer patients and their families under active treatment at Roswell Park Memorial Institute, a comprehensive cancer research and treatment center in Buffalo, New York. The Coping Inventory, Ways of Coping Scale, Locke-Wallace Marital Adjustment Inventory, and a Medical Index were used to assess patient's coping competence and medical experience as well as each parent's coping strategies and marital satisfaction ratings. The results revealed that coping competence was positively related to age among males while coping among females appeared to be independent of age. Self-coping among patients appeared to be strongly and negatively affected primarily by treatment side effects. The quality of the parents' marital relationship was significantly related to the child's coping competence, while parental coping strategies appeared to have much less influence. The findings raise questions about the potential benefits of intervening solely at the level of parental coping, at least when the intent is to improve the child's adjustment to illness. The results suggest that family health interventions need to be specific with regard to target outcomes at the individual, family sub-unit, and overall family levels. (NB)