OBJECTIVES: Rheumatoid arthritis (RA) has an extensive impact on quality of life (QOL) in RA patients. The aim of this study was to determine the effects of functional impairment, disease activity and duration of disease on QOL after controlling other risk factors. METHODS: This was a cross-sectional study comprised of 230 consecutive patients with RA from a rheumatology clinic. Quality of life was measured using Taiwan version of short form of World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Disease activity was assessed by the Disease Activity Score 28 (DAS28), functional disability by the Health Assessment Questionnaire (HAQ). Data on demographics, duration of disease, and income level were also collected. The QOL of the RA patients was compared with 229 age-, sex-, marriage-, and education-matched healthy control patients taken from a national survey in Taiwan. Multiple regression analyses were conducted to study predictors for impairment of QOL.  RESULTS: RA patients have significantly lower score in physical and psychological domain compared with healthy population, but they showed a higher score in the environment domain of WHOQOL-BREF. After adjustment of HAQ, age, and other factors, we found DAS28 score and duration of disease significantly affect the QOL on almost all four domains.  CONCLUSIONS: Functional impairment, disease activity and duration independently affect the QOL of RA patients. Future outcome research must take account of all these factors.