Objective To investigate the impact of family management on the psychological and behavioral problems of children with chronic diseases, and provide evidences for individualized family intervention. Methods A total of 618 caregivers of children with chronic diseases from 7 hospitals in Shanghai and Beijing were included, and Family Management Measure (FaMM) and Achenbach Child Behavior Checklist (CBCL) were employed for survey. The influencing factors of family management and psychological and behavioral problems of children were identified by univariate analysis and Pearson correlation analysis, and the variables with significant differences were selected to enter the multiple hierarchical regression model. Results Child´s daily life, condition management ability, family income (≥3 000 per month), living with grandparents and unemployed mother were significant predictors of childs internalizing behaviors. Child´s daily life, view of condition impact, parental mutuality, duration of condition (<1 year), male child and father with less education were significantly associated with child´s externalizing behaviors. Conclusion Family management is an important determinant of psychological and behavioral problems in children with chronic diseases. Improvement of key aspects of family management may directly affect the mental health of children.