In this cross-sectional study, we compared the quality of life (QOL) in transfusion-dependent thalassemic patients who survived matched sibling hematopoietic SCT (HSCT, n ¼ 24) with patients treated conventionally with transfusion and iron chelation (n ¼ 74). WHOQOL-BREF(HK) and PedsQL questionnaires were administered to patients aged 418 years and 5-12 years, respectively. Patients aged 12-18 years received both questionnaires. WHOQOL-BREF(HK) revealed post transplant patients rated overall health better than those treated conventionally (score 3.67 vs 3.06, P ¼ 0.01). They are less dependent on medical aids (3.87 vs 2.96, P ¼ 0.006), having higher activity level (4.00 vs 3.36, P ¼ 0.026) and better personal relationships (4.13 vs 3.69, P ¼ 0.014). Physical health domain score was better (75.20 vs 63.94, P ¼ 0.007). These differences remained significant after adjustment for comorbidities. PedsQL revealed post transplant patients rated better for running (3.53 vs 2.72, P ¼ 0.001) and sports (3.20 vs 2.64, P ¼ 0.038), even after adjustment for comorbidities, but were less satisfied for school absence to attend hospital (2.53 vs 3.29, P ¼ 0.03). Post transplant patients were significantly more likely to consider marriage (100 vs 75.7%, P ¼ 0.033), but not childbearing (66.7 vs 51.4%, P ¼ 0.28). In conclusion, transplanted thalassemic patients enjoy better QOL, mainly in physical health, compared with conventionally treated patients. This information is important to patients considering HSCT.