Purpose: Accepting and adapting to the child's diagnosis of Autism Spectrum Disorder (ASD) can be challenging for parents. We aimed to assess domains of parental adjustment namely despair, self-blame, and acceptance among parents whose children were diagnosed with ASD. Methods: A cross-sectional study was conducted among 111 parents of children with autism who attended Child and Adolescent Psychiatry Unit (CAPU), in a university teaching hospital in Kuala Lumpur, Malaysia. Sociodemographic profiles of both parents and children were gathered. Parental adjustment focusing on parental self-blame, despair and acceptance were assessed using self-reported questionnaires namely Adjustment to the Diagnosis of Autism (ADA). Results: Higher level of despair was associated with parents who have medical illness ([beta] = 0.214, p = 0.016) and children who received antipsychotic medications ([beta] = 0.329, p < 0.001). Parents with tertiary education ([beta] = -0.207, p = 0.023) and those with autistic child attended school ([beta] = -0.200, p = 0.037) have lower level of despair. Parents with medical illness ([beta] = 0.245, p = 0.008), child receiving antipsychotic medications ([beta] = 0.251, p = 0.005), Chinese ethnicity ([beta] = 0.185, p = 0.04), and child's gender ([beta] = 0.283, p = 0.003) were significantly associated with higher level of self-blame. Lower acceptance was found among Chinese parents ([beta] = -0.264, p = 0.005) while married parents had higher acceptance levels ([beta] = 0.215, p = 0.022). Conclusion: Parental adjustment involving domains of despair, self-blame, and acceptance were significantly associated with ethnicity of parents, educational level, parents' marital status and medical illness, as well as the ASD children's schooling status and type of medications used.