Medical care advancements for children with chronic kidney disease (CKD) receiving hemodialysis, peritoneal dialysis, or with a renal transplant have resulted in relatively improved long-term patient survival compared with adult patients with CKD. Optimal care for the pediatric patient with CKD requires attention not only to medical management, but also the psychosocial and developmental factors that either will ensure or prevent a pediatric patient's successful transition into adulthood. We review the range of issues that impact pediatric CKD patients' health-related quality of life (HRQOL), the history of pediatric CKD patients' HRQOL investigation, and the instruments currently available to assess HRQOL.