<p>Each year in the UK about 1,500 children are diagnosed with cancer. While survival rates have improved, about one fifth will die as a result of the disease. The uncertainty over whether a child will live or die while undergoing intensive treatment regimens has a significant effect on the child, parents and family. Much of the literature focuses on the effect of the illness on children and parents, but less is known about the needs of siblings. This article presents a narrative review examining the impact of a child’s cancer on siblings. Findings centred on four main themes: sibling adjustment and adaptation, emotional impact, siblings’ coping strategies and unmet needs. Finally, the implications for children’s oncology nursing practice are outlined.</p>