Purpose <p>There is no published information on preterm children’s activities and participation during middle childhood, a time when growth and development are characterised by increasing motor, reasoning, self-regulation, social and executive functioning skills. This study explored the health, activities and participation of children born very preterm during middle childhood (6–9&#xa0;years) from the perspectives of their parents.</p> Methods <p>This was a qualitative descriptive design. Twenty parents of 27 very preterm children born &lt; 32&#xa0;weeks gestation participated in semi-structured interviews to explore their child’s health, behaviour, functioning and participation in school, at home and in the community along with environment and personal factors that influenced the child’s activities and participation. Interview data were coded to each of the International Classification of Functioning in Disability (ICF-CY) domains.</p> Results <p>Parents reported a broad range of health needs and participation outcomes. Parents reported challenges related to respiratory health, mental health and behaviour, sleep, nutrition and feeding. The child’s participation and functioning were influenced by both personal and environmental factors including but not limited to parenting styles, education and learning support, access to health support and personal preferences and motivations.</p> Conclusion <p>Preterm birth is associated with impacts on the child’s health, activities and participation. This comprehensive view on the child’s health and wellbeing can aid clinicians in their management of these children.</p>