Background: Autism is a neurological disorder that affects social interaction and communication that can impede the daily functioning, educational and social attainments of autistic children. Psychological stress of parents of autistic children can negatively correlate with coping and social support. For families with autistic children, parental stress is significantly influenced by parental self-efficacy. Family counseling is the best solution for autistic children which can revitalize the role of family members. The study aimed to evaluate the effect of family counseling program on psychological stress and self-efficacy among parents of autistic children. Design: A quasi-experimental research design. Setting: This study was conducted at the Children Outpatient Clinics in El-Abbassia Hospital for mental health and addiction. Sample: A purposive sample of 60 parents of autistic children. Tools: A Structured Interviewing Questionnaire, Parental stress scale, and Parents' Perceived Self-efficacy Scale. Results: The study findings clarified that there were statistically significant positive correlations between parents' self-efficacy regarding care of autistic children, knowledge and reported practices post family counseling implementation. While there were a high statistically significant negative correlation between parents' self-efficacy regarding care of autistic children and stress level post family counseling program. Conclusion: Family counseling program had a positive effect on psychological stress and self-efficacy among parents of autistic children. Recommendations: Developing periodical family counseling and awareness programs for parents and family members having autistic children.