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To compare quality of life (QoL) in heart failure (HF) patients with preserved ejection fraction (HF-PEF) and HF patients with reduced ejection fraction (HF-REF) in a well-defined HF population.Patients with HF-PEF [left ventricular ejection fraction (LVEF) ≥40%] were matched by age and gender to patients with HF-REF (LVEF <40%). In the current study, we only included HF patients with a B-type natriuretic peptide level (BNP) >100 pg/mL. Quality of life was assessed by Cantril's Ladder of Life, RAND-36, and the Minnesota Living with Heart Failure questionnaire, and impairment of QoL was adjusted for by BNP as a marker for severity of HF. We examined a total of 290 HF patients, of whom 145 had HF-PEF (41% female; age 72 ± 10; LVEF 51 ± 8%) and 145 had HF-REF (41% female; age 73 ± 10, LVEF 26 ± 7%). All HF patients reported markedly low scores of QoL, both on the general and disease-specific QoL questionnaires. Quality of life between patients with HF-PEF and HF-REF did not differ significantly. When adjusting the QoL scores for BNP, an association between QoL and LVEF was not found, i.e. patients with HF-PEF and HF-REF with similar BNP levels had the same impairment in QoL.Quality of life is similarly impaired in patients with HF-PEF as in HF-REF. These findings further support the need for more pharmacological and non-pharmacological studies in patients with HF-PEF.Trial registration number: NCT 98675639.