The purpose of this study was to conduct a longitudinal examination of various dimensions of quality of life for patients following their first stroke and to identify variables that predict subsequent quality of life. 121 patients with a first stroke and 121 matched healthy controls from the same community were assessed at baseline and 1 year after discharge from hospital using a self-administered General Quality of Life Inventory. One year after discharge, the clinical condition of 84% of patients following a stroke had improved or they had fully recovered. However, their quality of life had not reached the level of the healthy controls. Of note was that 16% of patients whose stroke symptoms were unchanged or worse after 1 year of follow-up showed no change in quality of lith scores compared with baseline. One year after discharge, family and social support had significantly decreased and self esteem and body image were impaired compared with baseline, particularly for patients experiencing deterioration of their condition. Multiple stepwise regression analysis showed that quality of life was best predicted by the severity of the stroke, patients' outcome expectancy, their values of need level for life, and potential for neuroticism. Stroke was found to impair most aspects of patients' quality of life. During rehabilitation after stroke, more attention should therefore be paid, to adjusting patients' outcomes expectancy and their values of need level for life to a more realistic level and ensuring sufficient psychosocial support as well as active drug and physical therapy.