This study explores sibling support systems provided by Japanese and U.S. Child Life Programs in pediatric hospitals. Patients and family members encounter stress because of illness, injury, and medical procedures. In order for the healthy siblings to cope with their siblings' hospitalizations, psychosocial, developmental, emotional, and informational services are necessary to normalize their life. Active Child Life Specialists in the U.S. and Japan were recruited to participate in a survey and individual interviews about their services for healthy siblings. The results from the current study showed that both Japanese and U.S. pediatric hospitals had some kind of support for siblings. However, there were issues about sibling support systems, such as the acknowledgement of needs, the availability of siblings and CLSs, funding from hospitals, and the needs for advocacy.