Objective To investigate the impact of family management on family functioning of families with chronically ill children, and provide evidence for tailored family intervention. Methods A total of 618 primary caregivers for chronically ill children from 7 hospitals in Beijing and Shanghai were selected, and were surveyed with family management measure and Feetham family functioning survey. The influencing factors of family management and family functioning were identified by univariate analysis and correlation analysis, and the variables with P<0.05 in previous analysis were selected to enter the multiple regression model. Results Child´s daily life, condition management effort, family life difficulty, parental mutuality, living in urban area, employed mother, duration of condition (<1 year) and diagnosis (renal disorder or genetic condition) were predictors of family functioning. Conclusion Family management is an important determinant of family functioning. Improving the key aspects of family management may directly affect family functioning.