The pain, stiffness, swollen joints and progressive disability caused by rheumatoid arthritis (RA) makes it vital for healthcare providers to identify measures that enhance quality of life (QOL) for sufferers of this chronic disease. To date, very few studies have focused on QOL in middle-aged and older patients with RA in Taiwan. The purpose of this cross-sectional correlational study was to investigate the effects on QOL of disease severity, duration, pain, daily function, and sense of helplessness among middle-aged and older outpatients with RA. RApatients aged 50 and over were recruited (N = 158) from the outpatient clinic of a medical center in Taiwan. Data gathered and analyzed by hierarchical multiple regression included information on demographics, degree of pain, disease activity, daily function, and self-perception of helplessness. Length of time with RA diagnosis, severity of pain, disease activity, daily function, and sense of helplessness were found to correlate negatively with physical QOL (p < .01), and severity of pain, disease activity, daily function, and sense of helplessness were found to correlate negatively with the mental dimension of QOL (p < .01). Under hierarchical multiple regression, RA history, degree of pain, disease activity, daily function, and helplessness were found to explain 63.8% of total variance in the QOL physical component and 26.4% in the mental component. Degree of pain was the most significant factor to predict the QOL physical component (β = −.627, p = .000). Findings of this study suggest that health care professionals should consider how best to assist patients suffering from RA to relieve pain and delay the onset of disabilities. Findings also suggest that great benefit can be realized by lessening the sense of hopelessness felt by patients.