Chronic illness is common and has a profound impact on the education of affected children. A variety of approaches and programs to facilitate the transition from hospital to school for children with chronic health problems has been described in the literature. Traditional transition plans may no longer be effective because medical service delivery has changed to reduce long‐term hospital stays while increasing outpatient care. As a result, comprehensive hospital‐to‐school transitions increasingly emphasize home and family involvement that includes homebound instruction strategies, flexible school days, using differentiated instructional strategies, increasing child autonomy, and addressing affective issues. This article describes the needs of children with chronic illness, identifies educational programming consistent with the current health care system, and describes current hospital‐to‐school transition plans that integrate systemic needs of schools and health care systems with the needs of children with chronic illness. © 2007 Wiley Periodicals, Inc.