OBJECTIVES: To determine the relationship between Health-Related Quality of Life (HRQL) and asthma control in children as defined by the Canadian Pediatric Asthma Consensus Guidelines (CPACG). METHODS: Cross-sectional data on 879 children aged 1 to 18 from a completed study of children with a diagnosis of asthma were analyzed. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was administered by interview and information regarding the following asthma control parameters was collected: daytime symptoms, night-time symptoms, beta2-agonist use, physical activity level, exacerbations, and school absences. The Pearson correlation was calculated between the asthma control parameters satisfied and the PAQLQ domain scores. The level of agreement between the top quintile of each PAQLQ domain (= 80th percentile) and acceptable asthma control (all six parameters satisfied) was evaluated using the kappa statistic to measure agreement beyond chance. This was also done for unacceptable control (four or fewer out of six parameters satisfied) and the bottom quintile PAQLQ scores. RESULTS: The correlations between the number of asthma control parameters and the PAQLQ domains were 0.507, 0.467, and 0.474, (p<0.0001) for the symptoms, activity limitations, and emotional function domains respectively. The kappa for the top quintile of each PAQLQ domain and acceptable control was 0.206 for symptoms, 0.117 for activity limitations, and 0.184 for emotional function. The level of agreement between unacceptable control for the lowest quintiles domains was 0.128, 0.114, and 0.133 for symptoms, activity, and emotional function, respectively. CONCLUSION: The strong relationship between asthma control and HRQL supports a shared focus on control and quality of life in the CPACG. The low level of agreement between the control levels and the PAQLQ quintiles suggests further study is needed to determine optimal cut-offs for control levels and the marginal benefits from quality of life measures.