Background Coronavirus disease 2019 (COVID-19) pandemic affected the world especially those with chronic diseases. Diabetes mellitus (DM) is considered one of the most prevalent noncommunicable diseases. Type 1 diabetes (T1D) is one of the most common endocrine metabolic disorders around the world. This study aimed to assess the perceived fear of COVID-19 and its relationship to HRQoL among children and adolescents with T1D during the pandemic in Ismailia City. Methods This is a retrospective study carried out on T1D children and adolescents during pandemic in Ismailia City and conducted at Suez Canal University endocrinology outpatient clinic, Ismailia City, Egypt from June 30, 2021, to December 31, 2021. All participants were interviewed using a semi-structured demographic and clinical checklist, fear of COVID-19 Scale, and the short form 36 (SF-36) health survey. Blood samples were taken to analyze HbA1c for all patients. Results This study analyzed data from 68 children and adolescents with T1D with age ranged from 10 to 14 years, 58.8% were females and 55.9% had preparatory school education. 38% had BMI more than 30, 38.2% had DM for more than 5 years. HbA1C was more than 8 among 41.2%. 59% had low FCV-19 and 41% had high FCV-19. Mean PCS was 39.1±9.6 and 82% had poor PCS. MCS was ranging from 19 to 36 with a median of 28. Older age, preparatory educated, and larger BMI children had higher fears of COVID-19. Poor DM control, and poor adherence to glucose and diet showed higher FCV-19 scores. Higher PCS was associated with higher FCV-19 score. Using univariate logistic regression, age, HbA1C, type of insulin regimen, family history of DM, and FCV-19 score are predictors for PCS. While age, grade, BMI, HbA1C, adherence to glucose testing, type of insulin regimen, adherence to diet control, and PCS are predictors for FCV-19. Conclusion This study suggested that children and adolescents with T1D showed above-average levels of fear of COVID-19, and it may be associated with lower quality of life, especially physical aspects.