Aim: To examine whether the relationship between vision impairment and health-related quality of life (HRQoL) in nursing-home residents is impacted by coexisting cognitive impairment. Methods: This cross-sectional study involved a total of 382 English-speaking older adults (>55 years of age) with ≥13 on the Mini Mental State Exam (MMSE) from seventeen nursing homes in Birmingham, Alabama. Assessments were taken of visual acuity (Lighthouse Near Visual Acuity Test), cognition (MMSE) and health-related quality of life (Nursing Home Vision-Targeted Health-Related Quality of Life Questionnaire, VF-14, and the SF-36). Results: A greater portion of participants had both vision and cognitive impairments (38.5%) as compared with those with neither impairment (21.5%), vision impairment alone (13.4%), and cognitive impairment alone (26.7%). Cognitive impairment did not modify the impact of vision impairment on HRQoL. The reduction in HRQoL associated with vision impairment was similar for those with and without cognitive impairment. Conclusion: The deleterious impact of vision impairment on HRQoL in nursing-home residents was not exacerbated by the co-occurrence of cognitive impairment. Ageing-related visual impairment in nursing-home residents is often reversible through treatment leading to improved HRQoL, and thus it is clinically important to know that cognitive impairment is unlikely to interfere with this benefit.