Objective: The primary objective of this study was to explore the ability of a one-time drawing by proxy intervention to improve perception of quality of life for hospitalized children. Methods: The quantitative/qualitative study used a one-group pre-test/posttest design with 50 hospitalized children (ages 6-19 years), who participated in a 45 -60 minute intervention based on The Moon Balloon book. The PedsQLe Present Functioning VAS, a Parent Survey, and participatory observation were used to measure results. Results: Findings revealed a statistically significant improvement in perceptions of the child's momentary quality of life. Most parents reported learning something about their child that they had not known before. Children used imagery to express feelings about when images speak the unspoken, of beauty, of stress, and of transformation. Conclusions: Drawing by proxy improved children's perceptions of their present quality of life, and provided an effective method for expressing their thoughts and feelings. Studies are needed to determine the intervention's effectiveness in other settings and the characteristics individuals require for facilitating effective drawing by proxy interventions.