OBJECTIVE: This study aimed to investigate transitions in patterns of family resilience among Chinese families of children with chronic illness over a one-year period, as well as their relationship to parent-child interaction. METHODS: A representative sample of parents of children with chronic illness was drawn from two hospitals in Zhejiang Province, China, using convenience sampling. A total of 214 parents were assessed for family resilience, parent-adolescent communication, and child-parent relationships at three time points with a one-year interval: baseline (T1), 6 months (T2), and 12 months (T3) after the baseline survey. RESULTS: Latent profile analysis identified three distinct patterns, including (1) low family resilience, (2) moderate family resilience, and (3) high family resilience. The latent transition analysis revealed four transition patterns: stable low (72.4 %), stable moderate-high (22.5 %), improved from low to either high or moderate (4.2 %), and worsened from high to moderate (0.9 %). A one-way ANOVA revealed significant effects of the transition patterns of family resilience on open family communication, intimacy, and conflict within parent-child relationships. CONCLUSIONS: The high proportion within the "stable low" transition pattern and the enduring stability of family resilience over time underscore the significance of early intervention efforts aimed at enhancing family resilience or mitigating its decline among families of children with chronic illness.