The authors examined the longitudinal association between persisting posttraumatic stress disorder (PTSD) symptoms and multiple domains of life functioning in a community sample of 1,377 American Legionnaire Vietnam veterans first assessed in 1984 and followed-up 14 years later. Almost 30 years after their return from Vietnam, 10% of veterans continued to experience severe PTSD symptoms. At all levels of combat exposure, persisting severe PTSD symptoms were associated with worse family relationships, more smoking, less life satisfaction and happiness, more mental health service use, and more nonspecific health complaints at the 14-year follow-up. Further investigation is needed to determine whether the PTSD-functioning relationship is causal and if successful treatment of PTSD is associated with improvement in functioning.