This study examined how maternal chronic illnesses may affect children's academic achievement through parental involvement. A total of 189 mothers diagnosed with chronic illnesses, such as multiple sclerosis, diabetes, cancer, HIV/AIDS, chronic pain, asthma, myelodysplasic syndrome, and fibromyalgia, and with a child in middle school or high school (age 10-18 years) completed questionnaires assessing the demands of illness on family functioning, parental involvement, and the child's academic functioning. The results suggested that the majority of children of mothers with chronic illness were able to function adequately in terms of academic achievement. However, children's academic functioning might be at risk when family functioning was more disrupted as the result of maternal illness. Children's grades were negatively related to levels of demands of illness on family functioning. Levels of illness demands were negatively related to parental self-efficacy. Moreover, parental self-efficacy attenuated the effects of disruption in normal family functioning on children's academic achievement.