Literature reviews, parental consultation and multi-disciplinary input informed the development of a questionnaire to evaluate parental satisfaction with a regional paediatric intensive care service. The questionnaire was tested in a postal survey of 220 parents (response rate 50 percent) following their child’s discharge from the unit in order to measure satisfaction levels, determine positive service attributes and identify strategies for future service development. There was a high level of parental satisfaction with many aspects of the service, particularly the standard of care, the perceived competency of staff and the level of support and involvement experienced. Satisfaction with facilities was more variable, although this was largely in relation to the hospital as a whole, rather than paediatric intensive care (PIC) facilities. Respondents provided suggestions for service development, particularly regarding information, communication and preparation for the transition from PIC to ward environments. Many of the strategies identified to optimise the service were not dependent upon extensive organisational change or excessive additional resources.