Background/Objectives Little is known about the COVID-19 pandemic and its impact on the quality of life (QoL) of children with cancer, who may be more vulnerable to the pandemic’s effects. This paper examined: (1) associations between COVID-19 exposure and impact on QoL in children with cancer, and 2) potential moderation based on child’s cancer status (i.e., time since diagnosis, on/off treatment). Design/Methods Parents of children with cancer in the US were recruited February-April 2021 via Facebook and Momcology. Parents completed the Covid Exposure and Family Impact Scale a child quality of life measure. Controlling for parent age, income, child age, and child sex, we examined the indirect effect of COVID impact on the association between COVID exposure and child QoL, as well as the moderating role of cancer status. Results Children had lower QoL scores ( M=59.74) than previous reports of QoL in children with cancer ( t(735)=-6.98, p<0.001). Mediation analyses revealed a significant indirect effect (95%CI[-0.47,-0.13]): higher exposure was associated with higher impact ( a=0.47, p<0.001), which was then related to lower QoL ( b=-0.56, p<0.001). Treatment status did not affect this indirect path; however, the association between impact and QoL was stronger as time since diagnosis increased (95%CI[-0.08,-0.001]). Conclusions Parents who report greater COVID impact may also report lower QoL in their children with cancer, especially further from diagnosis. Clinicians should be aware of the negative impact of the pandemic on parents and screen for COVID-related distress. Additionally, results highlight the importance of long-term, family-centered care, regardless of children being on or off treatment.