Background Children and adolescent health has been recognised as an important indicator of a country’s development and global health. Adopting a health-related quality of life (HRQoL) approach can not only increase understanding of their own health but also help to establish policies that promote their safety and wellbeing.

Aims Evaluate HRQoL in a sample of Portuguese children and adolescents at primary care level, and assess age, gender and regional differences. Compare these results with the available European data.

Methods Cross-sectional observational study. Participants included 163 children and adolescents aged 8–18 years, presenting to a regular follow-up consultation at two primary care services (Lisbon and Oporto), during a six months period between 2012/13. HRQoL was assessed using KIDSCREEN-27, a self-report questionnaire that consists of five dimensions: Physical Wellbeing, Psychological Wellbeing, Autonomy and Parent Relations, Social Support and Peers, and School Environment. Statistics were calculated using SPSS Statistics 20.0.

Results The HRQoL scores, in all five dimensions, were consistently lower in female gender, adolescents and patients from Oporto region. However, statistically significant differences were found only for gender and age at the physical wellbeing dimension (p = 0.001 and p = 0.02, respectively). Compared to the European data our patients presented significantly higher HRQoL scores in all five dimensions (p = 0.025).

Conclusions The results underline the fact that females and adolescents should be the main targets when planning successful health policies and practices. Also, they call the attention for loco-regional differences that must be taken into account. Despite our patients presenting higher HRQoL scores, the results are according to the literature.