The quality-of-life construct can be used to assess how well an individual’s needs are met or being met by the society. However, in the dominant narratives of quality of life in old age, exploration of the impact of cultural differences on how older adults define and assess their quality of life has been limited. Moreover, the examination of heterogeneity within one culture and its influence on quality of life has been largely ignored. The present study compares the quality of life as defined by two samples of Nepali elderly women, those who live with their families and those who live in an old-age home, and presents data on factors associated with quality of life in the two samples. The results show that social and cultural norms, informed by religious principles that prescribe familial elder care, impact how quality of life is described by both groups of women.