PURPOSE: The aim of the study was to describe health-related quality of life (HRQOL) in persons with ostomies and to explore influencing factors. DESIGN: Secondary analysis of data from a cross-sectional survey. SUBJECTS AND SETTING: Eight hundred twenty-seven persons living with an ostomy were enrolled from 5 provinces and cities in China from October 2010 to November 2012; the final sample comprises 729 individuals who completed data collection. Their mean +/- SD age was 62.59 +/- 12.40 years (range 26-93 years). METHODS: Health-related quality of life was assessed using the Chinese language version of the City of Hope-Quality of Life-Ostomy Questionnaire-Chinese Version. Sociodemographic data, clinical characteristics, self-efficacy, adjustment to an ostomy, social support, and psychological state of patients were measured by a general information questionnaire. We also administered the Stoma Self-Efficacy Scale, Ostomy Adjustment Inventory-Chinese Version, the Social Support Revalued Scale, and Hospital Anxiety Depression Scale. RESULTS: Of the 729 ostomy patients, the overall HRQOL in ostomy patients was in the moderate range (mean score 5.19 +/- 1.29); scores of physical domain, psychological domain, social domain, and spiritual domains also in the moderate range (5.00 +/- 1.73, 5.97 +/- 1.59, 4.86 +/- 2.31, and 4.93 +/- 2.08 respectively). Multivariate analysis found that multiple factors influenced HRQOL in persons with an ostomy; they were gender, religious belief, and marital status, psychological factors depression and anxiety, and specific components related to social support, self-efficacy in ostomy care, and adjustment to an ostomy. CONCLUSION: Health-related quality of life among Chinese patients with fecal ostomies was less than optimal and influenced by multiple demographic and psychosocial factors. Additional research is needed to design strategies to improve HRQOL in this population.