Type 1 diabetes mellitus (T1DM) is a common childhood chronic disease that affects both the patient and the family. The aim of this study was to investigate caregiving challenges and their impact on the HRQoL of parents, family members, and caregivers parenting children with T1DM. A cross-sectional concurrent embedded mixed method inquiry was used. The family impact was assessed by parents completing the PedsQLTM Family Impact module (FIM), involving 155 parents and caregivers. The experience of caregiving was studied, in an audio recorded interview with 15 caregivers of children with T1DM and receiving medical follow-up for their children at Felege Hiwot Specialized Comprehensive Hospital, Tibebe Gion Specialized Hospital, and Addisalem Primary Hospital in Bahir in Dar City Administration. Qualitative data were analyzed thematically and descriptive statistics and multiple linear regressions were used to analyze quantitative data. The finding of the qualitative data revealed the challenges facing caregivers with T1DM children, impacts on HRQoL of parents and family members, the available social support to the needs of caregivers, and caregivers coping mechanisms. The quantitative data indicated the overall HRQOL of parents which was 57.12 (95% CI 55.79- 58.42), and their physical, emotional, cognitive, social functioning parents and family members. The sociodemographic and clinical characteristics of parents were correlated to their HRQoL at a statistically significant level (P < 0.05). This study indicated parents, particularly caregivers, are