This mixed methods research project with 16 participants focused on the spiritual and emotional needs of 8-16 year olds who had a sibling with a chronic rare disease was undertaken by the Centre for Paediatric Spiritual Care at Birmingham Children's Hospital. Three research tools were included: Kidscreen 52 Health-related quality of life questionnaire with proxy version, 1-1 semi-structured interviews and focus groups. The data was viewed through the lens of Maslow's Hierarchy of Needs and Nye's interpretation of them. Key findings showed that having a sick child impacted the well child in all the areas of Maslow's hierarchy but particularly esteem and self-actualisation needs. Early interventions are recommended to support the well sibling to seek to ameliorate the impact on spiritual and emotional needs of having a chronically sick sibling. Advocacy and awareness raising is beneficial.