We review evidence concerning health-related quality of life (HRQL) following paediatric haemopoietic stem cell transplant. The aims are to determine (1) HRQL compared with population norms; (2) changes in HRQL over time and (3) relations between pre-transplant variables (disease, individual and family resources) and survivor HRQL. Five databases were searched for articles published between January 1990 and February 2008. A total of 15 studies including 12 separate cohorts were identified. (1) HRQL was comparable with or better than population norms 6 months to 8 years post transplant. (2) HRQL was already compromised pre-transplant, further impaired immediately following conditioning, but improved 4-12 months post transplant. (3) Pre-transplant predictors of HRQL include family functioning and individual resources (for example, social skills). Identification of pre-transplant variables associated with long-term HRQL is invaluable to inform early psychological intervention and facilitate positive adjustment.