Almost 20 million children in the U.S. have a chronic illness. Chronic illness requires ongoing management in the home, often with complex, stressful regimens. The increased lifespan of chronically ill children may lead to increased long term psychosocial and physical sequelae. Enhancing the quality of life for these children could promote optimal long-term adaptation. Health benefits of companion animals have been described across psychosocial, physiological. and behavioral spheres for healthy children and children with disabilities. These benefits have not been empirically examined for chronically ill children. This paper uses a stress-coping model to examine the role animals may play in adaptation for children with chronic illnesses. The contribution of companion animals to the constructs within the model and the adaptation process is discussed. This model provides a potential theoretical framework for synthesizing literature and pursuing empirical work on the role of companion animals in chronic childhood illness.