OBJECTIVES: Health status is an important outcome measure in assessing treatment of asthmatic children. However, measuring quality of life in asthmatic children is difficult, requiring measures that are both sensitive to asthma and appropriate for children. This review summarizes and evaluates published quality of life instruments for pediatric asthma. METHODS: Articles were obtained by searching the Medline up to date. The following fields were extracted from articles for each instrument and summarized in a table: applicable age group, type of respondent, means of administration, items and domains, scaling, item selection, psychometric properties and versions in foreign languages. Standard psychometric measures including internal consistency and test-retest reliability, validity and responsiveness were chosen as evaluation criteria. Alpha 0.7-0.9 was chosen as acceptable range for reliability. RESULTS: 10 asthma- and children-specific instruments were identified (ASDQ, AMA, CAQ, CHSA, FSI, HAY, ITG-CASF, LAQCA, AAQOL, PAQLQ), in addition to three generic instruments applied in pediatric asthma. These instruments vary widely in age groups, length, items and domains, means of administration, psychometric measures, and versions and languages. The number of items ranges from 6-71, and number of domains 1-7. All instruments contain physical symptoms or activities domains. All measured internal consistency; only CAQ had domains with alpha lower than the minimum requirement. ASDQ, AMA, FSI and ITG-CASF had no test-retest reliability reported, and HAY and CHSA had domains with low reproducibility with alpha less than 0.7. Only HAY and PAQLQ demonstrated good responsiveness by showing changes in scores associated with clinical change. PAQLQ is the only instrument satisfying all selected criteria. CONCLUSIONS: Responsiveness to change is critical in quality of life outcomes studies, yet many instruments did not report this measure and therefore need further validation. Among 10 selected instruments, only PAQLQ satisfied the selected criteria and is recommended to use for ages 7-17.