• This study compared psychosocial and health factors related to school absence among 62 children with cardiac disease and 62 age-, sex-, and racematched peers without chronic health conditions. Parents of children with cardiac conditions perceived their children as more vulnerable and rated themselves and their children as having less control over improving their children's health status than did parents of the well children. Increased school absentee rates for the cardiac group were associated with measures of illness severity, parental patterns of absenting their child from school for minor illnesses, and decreased belief in their child's ability to improve his or her health status. For the well comparison group, increased absence was related to external health iocus of control beliefs, increased maternal sick days, and demographic factors. School absence was not significantly related to social adaptation, self-esteem, or school achievement for either the well or cardiac groups.