BACKGROUND: Quality of recovery, assessed by patients, is related to patients' satisfaction, and even to quality of life. Of numerous patient-based measures to evaluate the quality of recovery, a '40-item-quality of recovery (QoR-40)' has proved to be valid and reliable. Using this questionnaire, we evaluated the quality of recovery in the gynecological patients and tried to identify factors affecting the quality of recovery. METHODS: Patients undergoing gynecological surgery were asked to fill a questionnaire 8 to 9 p.m the day after the completion of anesthesia. Questionnaires were prepared after translation to Korean from 40-item-quality of recovery. From the anesthetic and recovery room records we collected data about patient's age, surgery types, anesthetic and surgical duration, recovery room stay, main anesthetic agents, and recovery room complications. RESULTS: A total of 383 patients completed the questionnaires. Patients aged under 40 got significantly lower QoR-40 scores than those aged over 40, especially in the dimension of pain (P < 0.05). Patients who had undergone laparoscopic surgery got higher scores than those had undergone non-laparoscopic surgery (P < 0.05). Patients who answered the questionnaires in more than 30 hours after the completion of anesthesia showed lower total scores than those who did in less than 30 hours, especially in the dimensions of emotional state and pain (P < 0.05). CONCLUSIONS: In gynecological patients, laparoscopic surgery improved quality of recovery. Quality of recovery was affected by age and survey time. Postoperative pain contributed to the decrease of the quality of recovery.