BACKGROUND: The status of development of instruments to assess the "health related quality of life' reflecting Korean's own language expression and culture is still far from satisfaction, despite their importance in building basic data for health promotion, evaluation of effectiveness of treatment, health policy and so on. METHODS: Symptom descriptions in both ill and healthy conditions were collected from 292, Koreans based on definition and damains of 'health related quality of life' which was established by 7 family physicians. The collected results were categorized into each domain and edited to be used as questions. Questions of health change and spiritual health domains were added. A selection of most pertinent items were pursued through the internal consistency analysis on 417 patients. Pretest was performed on 20 ordinary people to see if they think selected questions were understandable and related to their quality of life. RESULTS: A total of 1934 symptom descriptions were collected and categorized into 44 items of 7 domains including physical function, mental health, social function, pain, role, vitality, and health perception. Two items of health change and 3 items of spiritual health domain were added. Among those 49 items, 45 items of 9 domains were selected after discarding 4 items lowering internal consistency coefficient. Some items were corrected for more precise meaning, concise sentence, proper expression and word order, and nuance after pretest. CONCLUSIONS: We developed a Korean health related Quality of Life Scale(KoQoLS) reflecting Korean's own language expression and culture.