Background: The purpose of this study was to determine whether metabolic syndrome (MetS) and MetS management behaviors would be significantly associated with health-related quality of life (HRQOL) among patients with liver transplantation. Methods: Ninety-four patients who underwent liver transplantation were recruited at an outpatient clinic from a university hospital in Seoul. MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III. MetS management behaviors were measured by using the Evaluation Tool of a Lifestyle Habit for MetS Modification. HRQOL was measured by using the Medical Outcomes Study Short-Form Health Survey-36 II and analyzed by categorizing physical and mental quality of life (QOL). Results: The means of physical and mental QOLs were 82.3 and 82.8 scores, respectively. MetS prevalence was 72.3% and a mean of MetS management behaviors was 97.0. MetS prevalence was not significantly associated with either physical or mental QOLs. A total score of the MetS management behaviors was significantly associated with physical (β=0.42, P=0.008) and mental QOLs (β=0.44, P=0.001). Of the MetS management behaviors, diet control and drinking & smoking control were significantly associated with physical QOL (P<0.05 for all). Physical activity, diet control, and drinking & smoking control were significantly associated with mental QOL (P<0.05 for all). Conclusions MetS prevalence may not associate with HRQOL directly but MetS management behaviors may associate with HRQOL among patients with liver transplantation. Therefore, nursing strategies for promoting MetS management behaviors should be enhanced to improve their HRQOL levels in outpatient clinics and community settings.