The impact of systemic onset JCA on functional outcome was studied in a multidimensional construct. Twenty-one patients were subjected to auxologic evaluation, a laboratory check, pulmonary and cardiac function tests, radiographic evaluation, joint count on tenderness, swelling and function, ADL, health assessment (CHAQ), and psychosocial evaluation. Six of 21 patients had active systemic disease. Restrictive pulmonary function was found in 8/17 patients, 1/21 had pericarditis. Joint impairment was moderate. Functional limitations were mild. Self-esteem was positive. Parental report on functional limitation correlated significantly with joint impairment. Performance of daily activities correlated strongly with perceived competence. Active inflammatory disease did not correlate with joint impairment and functional limitation. Patients with systemic onset JCA develop mild functional limitations, which partially correlate with the more serious impairments. Pulmonary function disorders are a common impairment. Active inflammatory disease might influence functional outcome, but there is no evidence that it influences joint impairment outcome.