For some children and young people (CYP) with long-term physical health conditions (LTPHCs) attending school can be difficult. There is a lack of evidence documenting their school attendance experiences, how schools manage absence for these children, and subsequent effects. This study utilised an existing dataset from eighty-nine 11-18-year-olds in mainstream secondary schools in the United Kingdom across 11 LTPHCs that provided first-hand accounts about the children's experiences of school. Data pre-coded "attendance" were subject to thematic analysis to explore issues emerging. Findings showed attendance patterns varied, with some CYP missing little and others significant amounts of education. Children with LTPHCs wanted to attend school and did their best to navigate education alongside health. School systems for attendance were inconsistent and adversarial. Remedial and supportive action emerged as lacking, and children felt it was their personal responsibility to make up for lost time and missed work when absent. Decisions on whether they attended school, coupled with practices promoting high attendance had detrimental consequences for CYP with LTPHCs educationally, emotionally and socially. Overall, children with LTPHCs felt punished, stigmatised, unfairly treated, unequal and excluded. Results have implications for education, health, and policy practitioners to better plan and target attention so that the LTPHC cohort are treated sensitively and equitably and afforded their entitlement to education when they cannot go to school for health reasons often outside of their control.