Abstract Purpose Parents of children with cancer experience treatment-related employment disruptions. Most significant shifts occur during diagnosis and treatment. However, challenges can persist into survivorship. We explored employment changes during diagnosis and treatment among parents of children with cancer, and professional and financial impact during long-term survivorship. We investigated (1) if and what kind of employment changes occurred, (2) reasons for the changes, (3) differences between mothers and fathers, and (4) if parents experience long-term professional or financial impacts from their child’s past illness. Methods A questionnaire survey assessed employment changes during diagnosis and treatment and long-term professional and financial impacts. We described changes and reasons thereof and conducted logistic regression analyses to predict long-term impacts. Results We included 469 parents (59% female) of childhood cancer survivors (mean = 24 years after diagnosis). At time of treatment, 21% of parents reported employment changes: e.g., work time reduction (52%), quitting (27%), and taking unpaid leave (21%). Mothers were more likely to experience changes (OR = 2.00; p = .005). Most parents (87%), especially mothers, reported caring for their sick child to be one of the reasons for change. Some parents reported professional (5%) or financial long-term impact (5%). Financial impact was mainly associated with survivors experiencing late effects (OR = 10.51; p < .001), cancer relapse (OR = 3.96; p = .007), and survivors’ financial dependence (OR = 3.64; p = .005). Professional impact was associated with female sex (OR = 3.26; p = .029) and employment changes (OR = 2.39; p = 0.050). Conclusions Although most parents do not experience lasting effects on employment or finances, some continue to face challenges well into survivorship. Providing sustained, long-term support for these parents is essential.