Background:We used data from a random telephone survey of 2045 adults in Recife, Brazil to investigate the associations of health-related quality of life (HRQoL) with selected factors.Methods:We generated odds ratios of 4 HRQoL measures (perception of overall health, mentally unhealthy days, physically unhealthy days, and physically and mentally unhealthy days impeding usual activities) by levels of environmental factors (number of destinations, neighborhood aesthetics, neighborhood crime safety, neighborhood traffic interference, and neighborhood walkability), physical activity behavior, and participation in the Academia da Cidade Program (ACP).Results:Perception of overall health was associated with age, gender, education, body mass index (BMI) level, chronic disease, and having heard or seen an ACP activity. Mentally unhealthy days were associated with age, sex, BMI level, neighborhood aesthetics, and neighborhood crime safety. Physically unhealthy days were associated with age, sex, chronic diseases, leisure time physical activity, and neighborhood crime safety, and neighborhood traffic interference. Physically and mentally unhealthy days impeding usual activities were associated with chronic disease neighborhood crime safety, and traffic interference.Conclusions:The associations of HRQoL with environmental factors and health promoting programs may have public health policy implications and highlight the need for additional research into HRQoL in Brazil.