BACKGROUND: Leg ulcers have a major socio-economic impact because of their frequency and societal costs. Patients with leg ulcers experience major Health related Quality of Life (HrQoL) impairments. The aim of the present study was to assess the disease-specific HrQoL and the influence of care on HrQoL with leg ulcer. PATIENTS AND METHODS: A cross-sectional study was conducted in the metropolitan area of Hamburg to assess the quality of care as well as HrQoL in an unrestricted sample of patients with leg ulcers by questionnaires and subsequent clinical examinations. RESULTS: A total of 530 patients were consecutively recruited across all wound care provider sections in the metropolitan area of Hamburg. 53 % of the patients were highly or very satisfied with the health services provided. Significant correlations were found between the disease-specific HrQoL, patient satisfaction and satisfaction with wound treatment. Furthermore, significant predictors of HrQoL were: inadequate pain therapy, insurance status, wound size, time required for dressing changes and wound etiology. Most relevant predictors for satisfaction with health services were: HrQoL, duration of wound, health insurance status and treatment by office-based physicians. In contrast, no statistically significant association with HrQoL and satisfaction was found for gender, living district, education, number of dressing changes per week and the number of comorbidities. CONCLUSIONS: The results show that chronic leg ulceration has a major impact on patients HrQoL. Clinical and treatment characteristics, but not socio-demographic data, were predictors of HrQoL and satisfaction with health services. The systematic assessment of HrQoL in patients with leg ulcers across all sectors of health-care is a novum and provides important insights into the reality and quality of care.