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Abstract Background It is important for healthcare providers to pay attention to parents’ rearing style and children’s physical symptoms to promote a healthy quality of life among children with atopic dermatitis. We aimed to identify effects of parenting stress and co-parenting on marital conflict among parents of children with atopic dermatitis. Methods Participants were 161 fathers and 161 mothers raising seven-year-old children treated for atopic dermatitis. To confirm the effects of parenting stress and co-parenting on marital conflict, the “actor-partner interdependence mediation model” was used. To verify goodness-of-fit, maximum likelihood method was used, and a confirmatory factor analysis was conducted to confirm the validity of latent variables for model analysis. Results Fathers’ parenting stress had actor (β = −.46, p < .001) and partner (β = −.22, p < .001) effects on co-parenting, and mothers’ parenting stress had actor (β = −.20, p < .001) and partner (β = −.36, p < .001) effects on co-parenting. Fathers’ parenting stress only had an actor effect on marital conflict (β = .32, p < .001). Father’s co-parenting had actor (β = −.29, p < .001) and partner (β = −.22, p < .001) effects on marital conflict, and mothers’ co-parenting had actor (β = −.39, p < .001) and partner (β = −.19, p < .001) effects on marital conflict. There were significant differences between the two groups concerning three path coefficients: fathers’ parenting stress affected fathers’ marital conflict, fathers’ co-parenting affected fathers’ marital conflict, and mothers’ co-parenting affected fathers’ marital conflict. Conclusions It is vital for healthcare providers to seek ways to reduce the marital conflicts of parents of children with atopic dermatitis, including further examination of the role of co-parenting, to address children’s physical symptoms and promote their health. Our findings inform management and intervention programs for the families of children with atopic dermatitis.