An important and often neglected aspect in the evaluation of patient outcomes in venous disease is quality of life. This paper addresses the why, what, and how of measuring health-related quality of life (HRQL) in venous disease by providing an overview of practical and scientific considerations in developing and using measures of HRQL in general. It begins with a brief overview of developments in the field of measuring HRQL and the definition of HRQL. This is followed by a consideration of issues relevant to the assessment of HRQL including generic and disease-specific measures, multiple components of HRQL, different methods of measurement, measuring change, and cultural appropriateness of HRQL measures. In the next section, criteria for evaluating the scientific credibility and practical utility of HRQL measures are outlined, followed by a description of some widely used generic and disease-specific measures of HRQL, including measures of HRQL in chronic venous disorders of the leg (CVDL).