Many patient- and disease-related factors influence the quality of life (QL) after stroke. Few studies address the direct relation between cognition and quality of life. The objective of this study was to investigate the role of cognitive impairment in the QL of patients after stroke. We evaluated several variables including age, degree of paralysis, cognitive deficits and volume of infarcts, in 129 patients (64 men, 65 women; mean age 63.2, SD 14.6 years), who had been hospitalized a mean of 2.3 (range 0.25-4) years previously with ischaemic stroke. Cognitive function was assessed with the CAMCOG and QL with a visual analogue scale (VAS). Ninety-seven patients (75%) of our sample completed all the tests. Univariate analysis showed that substantial infarct volume, aphasia, impaired motor function, disability relating to activities of daily life, disturbed global functional health and impaired cognitive function were significantly associated with poorer QL. Age, sex and education of the patient, co-morbidity and location of the infarcts were not related to QL. Linear regression analysis revealed that disturbed global functional health, larger volume of infarcts and severity of aphasia were significant independent explanatory factors for poorer QL (adjusted R2 = 22%). In conclusion, we did not find a significant impact of cognitive impairment on the patients' QL. However, this conclusion is restricted to a relatively well group of stroke survivors.