Parental participation is one of the cornerstones of pediatric practice. Queen Elizabeth Central Hospital (QECH) is the major referral hospital in Malawi and caregivers stay with their children in the hospital and participate in the care. However, little was known about the perception of these caregivers regarding their participation in care of their hospitalised children. The aim of the study was to explore caregivers’ perceptions regarding parental participation in the care of their hospitalised child. A descriptive qualitative study was done using semi structured interview guide to collect data from 20 caregivers in the pediatric department. Thematic analysis was done guided by Collaizzi method. Seven main themes emerged from the data and these were lack of role negotiation by health care workers, inadequate role preparation for caregivers, perception of caregivers on care they provided to their hospitalised children, poor HCWs- caregivers’ communication, benefits of caregivers’ participation in care of hospitalised children, needs of caregivers participating in care of hospitalised children and overall impression of caregiver’s participation. The study findings showed that caregivers view their participation in the care of hospitalised children as appropriate, important and satisfying. However, gaps exist in the way caregivers participate in the care of their hospitalised children due to inadequate role negotiation, role preparation for caregivers and inadequate information for caregivers. The researcher recommends that management should develop protocols and guidelines for the implementation of parental participation in care of hospitalised children to promote best practices.