Chronic illness affects all members of the family, including siblings. Siblings of children with myelomeningocele have been studied infrequently. This descriptive study examined the perceptions and concerns of the school-age siblings of children with myelomeningocele and compared sibling responses with maternal perceptions of the sibling relationship. The effects of age, birth order, and gender were also examined. Fifteen children and their mothers participated in the study. Data were collected through a sibling interview and maternal survey. Qualitative analysis of the sibling responses revealed a high level of empathy and concern for their brothers and sisters with myelomeningocele. Maternal responses yielded similar findings. No statement could be made regarding the effects of age, birth order, or gender upon the sibling relationship. Nurses are in a unique position to assess the perceptions and concerns of siblings, and to intervene to ensure that their needs are met and their contributions to family life recognized.