Autism spectrum disorder (ASD) is a developmental disability that can lead to substantial social, communication, and behavioral difficulties. Challenges in caring for a child diagnosed with ASD impact the caregiver's health-related quality of life (HRQoL), family functioning and total family impact. The quality of life in individuals varies depending on living areas as living standards in rural areas are not the same as in urban areas. However, only a few researchers make detailed studies about disabled children's families in rural areas. The findings that used samples which only represented the families of children with ASD in urban areas might have restricted generalization to those families residing in rural areas who cannot access professional service. Thus, this study is conducted to compare the HRQoL and family functioning as well the total family impact as a whole among caregivers of autistic children who are living in rural and urban areas. A total of 112 caregivers who send their autistic children to special education integrated program (SEIP) in Selangor, Malaysia, was participated in this study. The research instrument used was the Malay Version of the PedsQL Family Impact Module. An independent t-test was run to identify any significant difference between living areas (urban, rural) and family impact scores (Total Impact, Parent HRQoL Summary, and Family Functioning Summary) among the participants. The mean difference between both living areas for HRQoL Summary Score of the parents/caregivers, Family Functioning Summary Score, and Total Impact Score was 1.52, 1.31, and 2.63, respectively. It revealed that both populations were impacted by their autistic children. However, there is no significant difference between living areas and all the family impact scores among caregivers of children with ASD. This study emphasizes the provision of support and help must be given to both populations equally but must fit the populations' needs.