OBJECTIVES: The Brace Questionnaire (BrQ) is a recently-developed, condition-specific tool used to measure quality of life (QoL) in subjects treated with spinal bracing. While corrective bracing for adolescent idiopathic scoliosis (AIS) has more favourable outcomes when patients are compliant, one must appreciate that bracing itself may be a stressful and traumatic experience, and compliance with a bracing protocol is likely to be dependent upon patients' physical, emotional and social well-being. Using the BrQ we sought to explore relationships between QoL and compliance with treatment. METHODS: The BrQ was administered to 31 AIS patients after a minimum of 1 year of wearing a brace for 1 year. Subjects were 13-16 year-old girls with significant deformity (Cobb angles 25-40 degrees). Participants were divided into two groups according to their level of compliance with the bracing protocol. BrQ sub- and total scores were compared between the two groups using the t-test for comparison of means. RESULTS: Twenty participants were classified as compliant and 11 as non-compliant. Mean total BrQ scores (expressed as %) were 83.7 for the compliant group and 64.4 for the non-compliant group (p<0.001). The compliant group scored significantly higher in six of the eight domains that make up the BrQ. Compliant patients had greater vitality and self esteem, and functioned better in those domains covering physical, emotional and social performance. CONCLUSIONS: Poor QoL adversely affects compliance in AIS patients requiring a brace. Non-compliant patients lack vitality and self esteem, and function poorly in the physical, emotional and social domains. Quality of life for adolescents with idiopathic scoliosis may relate more to psychosocial coping mechanisms than to physical deformity and its consequences. It is important for remedial programmes to consider personal, peer and family issues as part of improving QoL, promoting compliance and correcting deformity.