Objective: To determine whether a correlation exists between the Model for End-Stage Liver Disease (MELD) score and health-related quality of life (HRQOL) after liver transplant (LT). Design: Prospective cohort. Setting: University hospital. Patients: Adult LT recipients (N = 209). Main Outcome Measures: Postoperative HRQOL over a 1-year period after LT as measured via multiple regression-based path analysis testing the effects of the MELD score, preoperative variables, and postoperative variables on scores on the physical component summary and mental component summary scales of the 36-Item Short Form Health Survey and on composite physical and mental HRQOL scores derived from multiple scales. Results: The MELD score (β =.16), cholestatic cirrhosis (β =.12), autoimmune/metabolic disease (β =.18), neo-plasm (β =.23), time after LT (β =.16), and the Karnof-sky score (β =.49) had significant effects on the physical component summary scale score. Autoimmune/ metabolic disease (β =.16) and the Karnofsky score (β =.25) had significant effects on the mental component summary scale score. The MELD score (β =.15), high school education (β =.15), college education (β =.17), autoimmune/metabolic disease(β =.15), neoplasm (β =.23), time after LT (β =.11), and the Karnofsky score (β =.51) had significant effects on the composite physical HRQOL score. Autoimmune/metabolic disease (β =.23), neoplasm (β =.15), and the Karnofsky score (β =.42) had significant effects on the composite mental HRQOL score. Conclusions: An increasing MELD score, when computed without any diagnosis-based exception points, was associated with improved physical HRQOL in the first year after LT. The MELD score did not affect mental HRQOL. © 2009 American Medical Association. All rights reserved.