OBJECTIVES: The PAR-ENT-QoL was developed in French. It is designed to assess the effect on family life of children's Rhinopharyngitis and otitis. This study's first objective was to produce a US English version to be used as the basis for other, conceptually equivalent and culturally relevant, translations and then to perform these. METHODS: An unusual methodology was employed to create the US English version: 2 translations into English, reconciliation by a bilingual native English consultant based in France, ‘back' translations into French, back translation review, developer review, cognitive debriefing interviews with 5 members of the target population, 2 proofreadings; with input at every stage from both consultants. The translations from English employed a standard methodology: 2 forward translations, reconciliation, 2 back translations, back translation review, or in-country review; developer review, cognitive debriefing interviews as before, 2 proofreadings. RESULTS: Numerous cultural and linguistic issues arose, some of them particular to this methodology: •In US English “Rhinopharyngitis” and “otitis” were not understood by the general population so an explanation was added in the first instance. •Some in-country consultants were fluent in French so they worked directly from the English and used the French version as a guide. •‘Vous' in French means ‘you' but can be singular or plural. In the context this was translated as ‘you or your partner'. •The French ‘contrarié' covers numerous English meanings including “upset” and “frustrated” – after developer input, ‘upset' was used. CONCLUSIONS: The simplest way of performing translations from a non-English original questionnaire is to create an English version as a basis for other translations. This now exists, and the PAR-ENT-QoL has been rigorously translated and linguistically validated into 16 languages. A number of cultural and linguistic issues became apparent and were resolved. The measure is now appropriate for use in multinational trials.