A reduction in symptoms, increased longevity, and improved quality of life (QoL), are goals of cardiac surgery. We measured QoL in 108 adult cardiac surgical patients at about three years after cardiac surgery, and assessed the predictive ability of a 40-item quality of recovery (QoR-40) score. Our follow-up rate was 86% (n = 93). When compared with preoperative status, QoL was improved at three years after surgery (P < 0.0005). The dimensions of QoL that were most affected were physical functioning, role limitations due to physical problems, vitality, social functioning, and role limitations due to emotional problems (all P < 0.005). There was a mild correlation between the day 3 QoR-40 and the three year SF-36, r = 0.23 (P = 0.029). There was a strong correlation between the three year QoR-40 and the three year SF-36, r = 0.73 (P < 0.0005). The QoR-40 and SF-36 done at three years after cardiac surgery demonstrated good internal consistency, QoR-40 alpha = 0.86 (P < 0.0005), SF-36 alpha = 0.91 (P < 0.0005). A poor quality recovery in the days after surgery can predict a poor QoL at three years after surgery. The QoR-40 is a valid and reliable measure of quality of recovery after surgery and anaesthesia. The QoR-40 is a useful, patient-oriented method of assessing recovery from anaesthesia and surgery.