The relationships between illness perceptions, coping and adjustment were investigated in the context of chronic fatigue syndrome (CFS). Self‐reported illness perceptions, coping, disability levels and psychological well‐being were assessed in a national sample of 233 CFS sufferers. A series of regression analyses indicated that illness perceptions explained a greater percentage of the variance in levels of disability and psychological well‐being than did the coping strategies used by the participants to manage their illness. The illness perception components of illness identity, emotional causes, controllability and consequences had the strongest overall association with adjustment such that participants with a strong illness identity, who believed their illness was out of their control, caused by stress and had very serious consequences were most disabled and psychologically impaired. Disengagement coping strategies and venting emotions were also associated with greater disability and poorer psychological well‐being, while positive reinterpretation and seeking social support were positively related to psychological well‐being. The potential role of illness perceptions in the maintenance of CFS is