AIM To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD). METHODS This was a cross-sectional study conducted at the First Department of Pediatrics of the University of Athens at the "Aghia Sophia" Children's Hospital. Children diagnosed with Crohn's disease (CD) or ulcerative colitis (UC), who were followed as outpatients or during a hospitalization, participated, after informed consent was obtained from their legal representative. QOL was assessed by the IMPACT-III questionnaire. Demographic data and disease characteristics were also collected. Statistical analyses included parametric (Student's t-test and Pearson's r) and non-parametric (Mann-Whitney test, Fisher's test and Spearman's rho) procedures. RESULTS Ninety-nine patients (UC: 37, 73.0% females, CD: 62, 51.6% females), aged 12.8 +/- 2.6 years were included. Overall, as well as, sub-domain scores did not differ between UC and CD (overall score: 73.9 +/- 13.3 vs 77.5 +/- 11.2, respectively, p = 0.16). In the entire sample, total score was related to physician's global assessment (PGA, patients classified as "mild/moderate" active disease had, on average, 14.8 +/- 2.7 points lower total scores compared to those " in remission", p < 0.001) and age at IMPACT completion (Pearson's r = 0.29, p = 0.05). Disease activity assessed by the indices Pediatric Ulcerative Colitis activity index, Pediatric Crohn's disease activity index or PGA was significantly associated with all subdomains scores. Presence of extraintestinal manifestations had a negative impact on emotional and social functioning domains. CONCLUSION Disease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical remission Key words: Inflammatory