Objective <p>This study intended to explore behavioral and emotional problems and quality of life, as well as their related factors in Chinese children with Langerhans cell histiocytosis (LCH).</p> Methods <p>This was a cross-sectional study. Subjects were included from April 2023 to September 2023. Child behavior checklist (CBCL), pediatric quality of life inventory™ version 4.0 (PedsQL^TM4.0), and version 3.0 (PedsQL^TM3.0) Cancer Module were used to assess behavioral and emotional problems and quality of life.</p> Results <p>A total of 120 children with LCH were included. Twenty-six (21.7%) children had behavioral and emotional problems. Age at diagnosis ≥ 4 years [odds ratio (OR) = 0.344, <i>P</i> = 0.022] and major caregiver with an educational level of junior college and above (OR = 0.314, <i>P</i> = 0.035) were independently associated with a lower possibility of achieving CBCL total problem score ≥ 35. Electronic product usage time ≥ 2&#xa0;h per day (<i>B</i>=-6.024, <i>P</i> = 0.011) and caesarean section (<i>B</i>=-6.006, <i>P</i> = 0.012) were independently related to a lower total PedsQL^TM4.0 score, while age at diagnosis ≥ 4 years (<i>B</i> = 9.183, <i>P</i> = 0.004) showed an inverse trend. Second-line treatment was independently related to a lower total PedsQL^TM3.0 Cancer Module score (<i>B</i>=-5.578, <i>P</i> = 0.021).</p> Conclusion <p>In this study, 21.7% of Chinese children with LCH exhibit behavioral and emotional problems. Age at diagnosis &lt; 4 years, major caregiver with an educational level of high school and below, electronic product usage time ≥ 2&#xa0;h, caesarean section, and second-line treatment are related to behavioral and emotional problems and impaired quality of life in Chinese children with LCH.</p> Clinical trial number <p>Not applicable.</p>