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Objectives: Adolescent idiopathic scoliosis (AIS) may negatively affect both the quality of life of adolescents and the quality of life of their families (FQOL). Therefore, the analysis of objective and subjective determinants of FQOL in families of children and adolescents with AIS undergoing long-term conservative treatment becomes important and will allow for a better understanding of factors that may have a significant impact on the prognosis and clinical treatment outcomes. Methods: The analysis covered a total of 200 families of children and adolescents aged 7-18 from the Podkarpackie region (Poland). The medical history chart and the original physical examination card, as well as the Family Adaptability and Cohesion Scales (FACES III) and the Family Quality of Life Scale (FQOL), were used in this study. Results: Families of adolescents without AIS demonstrated significantly higher levels of family cohesion and adaptability compared with families of adolescents with AIS (p < 0.001). The mean overall FQOL score was significantly lower in the AIS group (75.33 ± 9.18) than in the control group (86.97 ± 7.91; p < 0.001, r_rb = 0.58). Multivariate analysis indicated that family adaptability was an independent predictor of FQOL in the AIS group, with higher adaptability associated with lower overall FQOL and reduced scores in parental functioning and emotional well-being domains. Conclusions: A long process of AIS treatment can cause crisis situations for patients and their families and influences both the physical and mental health of patients by changing their family's quality of life (FQOL). Early identification of families characterized by diminished cohesion and adaptability enables the integration of psychopedagogical support and family consultations into standardized care. Such a multidimensional approach may enhance therapeutic prognosis and accelerate the rehabilitation process.