Objective To survey the health-related quality of life (HRQoL) among the stroke patients living in rural areas of Western China and analyze the influencing factors. Methods From November 2018 to March 2019, stratified sampling was used to select the stroke patients in Hancheng, Shaanxi Province, and Pingluo, Ningxia Hui Autonomous Region. The basic information of stroke patients in the selected areas was collected by questionnaire, and the HRQoL of the participants was investigated by EuroQol Group′s 5-domain (EQ-5D) scale. Results Among the 362 distributed questionnaires, 349 pieces(96.4%) were collected as valid. The participants were at a mean age of (67.48±10.21) years, body mass index (BMI) of (23.77±3.00)kg/m², and health state utility value of 0.645±0.310. In the 5 dimensions of EQ-5D, the daily activity capacity was the most difficult, accounting for 63.3%. Univariate analysis showed that the main caregivers, family monthly income, and stroke type were the influencing factors for EQ-5D score (P<0.05). Tobit regression model indicated that EQ-5D score differed statistically in those at ages, with occupations and stroke types (P<0.05). Conclusion The stroke patients in rural areas of Western China are in poor quality of life. Age, occupation, main caregivers, family monthly income, and stroke type have significant effects on HRQoL.