This study compared the subjective and objective quality of life and needs of patients with paranoid schizophrenia between inner city areas in Berlin (69 patients) and London (75 patients). Quality of life was assessed by means of the Lancashire Quality of Life Profile (German version Berliner Lebensqualitatsprofi), and need was quantified using the Camberwell Assessment of Need (German version Berliner Bedurfnisinventar). The hypotheses tested were that although Berlin patients may rate more highly on objective quality of life measures, the subjective quality of life would be similar as patients would judge their quality of life against their local expectations. The findings supported the first part of the hypothesis as on the objective measures the Berlin group was significantly better off financially and in living conditions, and had significantly fewer material needs. However, despite having more severe psychopathology, the Berlin groups' scores on global subjective quality of life were also higher. On particular life domains, subjective quality of life did not always reflect objective measures and sometimes went in the reverse direction. We concluded that the relationship between subjective and objective quality of life is complex, and great caution must be exercised in making quality of life comparisons between different cultures.