Objective <p>This study aims to investigate the mediating role of self-consciousness between the quality of life and family functioning in girls with precocious puberty.</p> Methods <p>A convenience sampling method was employed to select 314 female children aged 8–12 years with precocious puberty who were receiving outpatient treatment at a tertiary hospital in Sichuan Province, China, between March 2022 and March 2023 for a questionnaire survey; The general data survey form, the generic core scale of children’s quality of life, the Piers-Harris Children’s Self-Concept Scale, and the Family Function Assessment Scale were used as research tools; Pearson was used for correlation analysis, and AMOS 26.0 was applied to construct the mediating effect model and test between family functioning and quality of life of precocious puberty girls’ self-awareness.</p> Results <p>Family function (<i>β</i> = 0.270, <i>P</i> &lt; 0.001) and self-awareness (<i>β</i> = 0.480, <i>P</i> &lt; 0.001) had a positive predictive effect on the quality of life of precocious puberty girls, and self-awareness had a partially mediating effect between the quality of life of precocious puberty girls and their family function (β = 0.293, <i>P</i> &lt; 0.001), and the mediating effect accounted for 52.04% of the total effect.</p> Conclusion <p>Improving family functioning and self-awareness in girls with precocious puberty is closely related to improving their quality of life. Medical professionals should consider multidisciplinary association to help precocious puberty girls create a favorable family atmosphere and promote the girls to establish a positive sense of self in order to improve their quality of life.</p>