In this study, parents describe siblings' adjustments to a brother's or sister's hospitalization. The families of children hospitalized for relatively usual, non-life-threatening reasons were investigated. The relationship between patterns of sibling participation and family structure and sibling response were explored. Sibling responses were studied through intensive interviews with parents. Interviews were conducted using semistructured interview guides and took place within 24 hours of the child's admission and again from 4 to 6 weeks after the child's discharge from the hospital. Families (N = 59) were divided into those in which siblings participated actively in adjusting to the hospitalization and those in which siblings were passive participants in the adjustment process. Sibling participation was discussed as a function of family structure. Parents reported few negative sibling responses to hospitalization. The quality of sibling response was related to the amount of change experienced.