: Long COVID (LC) has emerged as a significant epidemiological and public health issue, affecting patients' health-related quality of life (HRQoL). This study explored the impact of LC on HRQoL in COVID-19 survivors in the Eastern Province of Saudi Arabia and examined the sociodemographic and clinical factors that influence HRQoL. : This cross-sectional study included 1024 participants, and data were collected through face-to-face interviews using a structured questionnaire that incorporated the EQ-5D-5L tool to assess HRQoL. Sociodemographic information, acute COVID-19 symptoms, and LC symptoms were recorded. Statistical analyses included bivariate analyses and multivariable generalized linear modelling. : Of all participants, 63.8% reported experiencing LC symptoms, with fatigue, cough, and anosmia being the most common. Participants with LC had significantly lower HRQoL scores (mean EQ-5D-5L index score, 0.93) than those without LC (mean score, 0.98; < 0.001). The key factors influencing lower HRQoL included a higher number of LC symptoms, older age, the presence of pneumonia during acute COVID-19, and pre-existing conditions such as anxiety and hypertension. : LC negatively impacts HRQoL, with older age, chronic diseases, and the number of LC symptoms being strong predictors of poor outcomes. Interventions targeting rehabilitation and psychosocial support are critical for improving the long-term health outcomes of patients with LC.