Objective The objective of this study is to examine the relation between parental coping style and the risk of parental and child posttraumatic stress symptoms (PTSS) among pediatric cancer survivors. Methods Child survivors of cancer ranging from 6 to 16 years of age (N = 111) completed standardized measures of depression and PTSS, while their parents completed standardized measures of PTSS and coping styles. Results Correlational analyses revealed that active and passive coping strategies were positively related to parental PTSS. Although child and parental PTSS were significantly related to each other, only one parental coping strategy—using substances—was significantly related to child PTSS. Regression analyses revealed support for a mediation and not for a moderation model for this relation, thereby suggesting that the relation between parental and child PTSS is mediated by parental substance use. Conclusions Clinical implications including identifying risk factors for PTSS among pediatric cancer survivors are discussed. Copyright © 2013 John Wiley & Sons, Ltd.