PURPOSE: The purpose of this study was to determine the relationships of pain cognition, performance status, and hope with health-related quality of life. METHODS: Patients(n=149) with various cancer diagnoses completed the SF-36 standard Korean Version and the Herth Hope Index. The Perceived Meanings of Cancer Pain Inventory was used to measure the cognition dimension of pain, whereas the Brief Pain Inventory Korean version was used to represent the sensory dimension of pain. RESULTS: The patients in the pain group had significant differences in the three dimensions(loss, threat, spiritual awareness) of pain cognition. There were statistically significant negative correlations between the three dimensions(loss, threat, and spiritual awareness) of pain cognitions and SF-36 dimension, and the positive correlations between challenge dimension and SF-36 dimension. Hope had the positive correlation with SF-36 dimensions. CONCLUSION: Pain has a negative impact on health-related quality of life, especially on physical health. However, patients who ascribed more positive meaning to their pain, tended to have a higher quality of life. Therefore, nursing intervention to reinforce the positive aspects of pain cognition is to empower patients to create a sense of control and assume an active role in pain management and quality of life.