OBJECTIVES: This study evaluated the psychometric properties of the Chinese Mandarin HeartQoL Questionnaire (C-HeartQoL), an ischemic heart disease (IHD) specific health-related quality of life instrument, among Mainland Chinese patients with angina, myocardial infarction (MI) and heart failure (HF). METHODS: The English version HeartQoL questionnaire was translated into Chinese using the forward-backward translation approach. A cross-sectional study was then conducted in patients with angina, MI and HF using C-HeartQoL, SF-12, and HADS. Internal consistency reliability was evaluated. Convergent validity was assessed with Pearson correlations. Divergent validity was determined using age, gender, SF-12 general health status, HADS anxiety and depression, and functional status as predictor variables. RESULTS: In total, 406 IHD patients (angina=111; MI=150; and HF=145) were enrolled in China. Patients with MI (2.04 ± 0.72) had higher HeartQoL scores than patients with angina (1.99 ± 0.75) or heart failure HF (1.27 ± 0.83). Cronbach’s α internal consistency reliability was ≥0.90. The correlations between the physical subscales and the emotional subscales in C-HeartQoL and SF-12 were strong ranged from 0.52 to 0.82. Higher HeartQoL scores were reported by younger than older patients and by male than female patients. Higher HeartQoL scores were observed consistently in patients reporting ‘Excellent/very good’ health status than by those reporting ‘Good/fair’ or ‘Poor’ status and by patients reporting ‘Good/fair’ health status than by patients with ‘Poor’ status and by patients without anxiety or depression than patients with anxiety or depression. Patients with functional class ‘I/II’ angina or heart failure had higher HeartQoL scores than patients classified as functional class ‘III/IV’. CONCLUSIONS: The C-HeartQoL demonstrates good internal consistency reliability and construct validity in patients with IHD and in each diagnostic subgroup. The data support the use of the Chinese HeartQoL by researchers and clinicians to assess and compare health-related quality of life in Chinese patients with IHD.