Middle-aged children may cope in different ways with interpersonal tensions with their aging parents. This study examined coping strategies as a function of parent's age and disability and children's emotions (i.e., guilty feelings and worry). Middle-aged children (N = 378) reported coping strategies when encountering interpersonal tensions with each of parents (N = 482): engagement, acceptance, avoidance, and confrontation. Middle-aged children also indicated how guilty and worried they felt about each parent. Multilevel models indicated that middle-aged children were most likely to use engagement and acceptance strategies, followed by avoidance, and least likely to use confrontation. Results also revealed that middle-aged offspring were more likely to use engagement toward their parents who were older and acceptance toward parents with more disabilities. Furthermore, when middle-aged children had stronger feelings of guilt toward parents, they were more likely to be avoidant and less likely to engage with parents. Worries about parents were positively associated with the use of engagement strategies.