Background: The burden of living with pediatric end-stage renal disease (ESRD) impacts quality of life (QOL), a concept that has been commonly associated with adherence, morbidity, and health outcomes. There are many definitions for QOL but they rarely take the pediatric perspective into consideration and they may not apply perfectly to Muslim and Arabic societies. Objectives: The aim of this paper is to clarify the concept of QOL and identify the conceptualizations behind it and to provide some insights to QOL research in children and in the Arab world. Results: The defining attributes of QOL include the level of satisfaction, the individual perception of well-being, and the life domains. QOL is defined as a subjective evaluation of satisfaction of well-being across life domains based on individual perception of life in the context of culture, values, and beliefs. The antecedents of QOL include cognitive capacity, basic functioning ability, and life events. The consequences of QOL include happiness and goals accomplishment. QOL is measured using generic and disease specific measures which ask individuals to rate their satisfaction with life domains such as physical, emotional, social, and vocational. In children, QOL measures consider developmental changes, cognitive abilities, and parent-proxy reports. In the Arab world, QOL is rarely defined or measured from an Arabic and Islamic perspective. Conclusion: All attempts must be made to address QOL from a cultural, linguistic, and developmental standpoint that can reflect the complex nature of QOL in the pediatric population.