Background: Pediatric medical interpreters facilitate communication among patients, families, and clinicians across linguistic and cultural barriers in high acuity, distressing medical encounters. Few studies explore distress among trauma interpreters, and even less research exists on distress and supports for coping among pediatric medical interpreters. Further research is important given the likely risk of secondary traumatic stress and burnout in this population, especially among interpreters working in high-acuity medical settings. This study explores distress among pediatric medical interpreters, available supports and resources for coping with distress, barriers to accessing support, and further resource needs.Methods: Thirteen Spanish-English interpreters at a midwestern pediatric hospital completed a demographic survey and one-on-one virtual semi-structured interviews. Participants were asked about contributors to distress, experiences accessing resources for coping with distress, coping strategies they employed, and suggestions about resources needed to help manage distress. Interviews were qualitatively coded using inductive thematic analysis.Results: Interpreters described that encounter type, setting, presence of emotional content, interpreter role, feeling uncertain or unprepared, consecutive consults, and consults related to their own life contribute to distress. Resources used for coping with distress were organizational (e.g., training programs), interpersonal (e.g., manager support), and intrapersonal (e.g., focus on interpreting). Interpreters shared challenges to accessing supports (e.g., employment status, exclusion from medical team debriefings).Interpreters suggested resources such as support groups, team debriefs, and training to facilitate coping with distress.