Purpose The purpose of this study is to assess psychological distress among parents of children with autism spectrum disorder (ASD), self-esteem as a predictor of such distress and the effect of coping strategies. Design/methodology/approach A descriptive correlational study design was conducted using a convenient sample of parents of ASD children (N = 93). Findings This study revealed that the parents of an ASD child experienced a high level of anxiety (M = 15.89), a moderate level of depression (M = 15.85) and a mild level of stress (M = 16.86). Parents of ASD children also reported a low self-esteem score (M= 13.27). Mothers of ASD children reported higher levels of psychological distress, lower levels of self-esteem and more frequent utilisation of maladaptive coping strategies than fathers of ASD children. Practical implications Parents of children with ASD experience a significant level of psychological distress; however, this may be improved by developing programmes and psychological interventions focused on improving parents’ self-esteem and using more active coping strategies. Originality/value To the best of the authors’ knowledge, this is the first study conducted in Saudi Arabia that predict the psychological status among family caregivers of an autistic child.