Background This review traces the 12-year history of an international collaboration of researchers-the WHOQOL Group-who were brought together by the World Health Organisation to develop and produce a cross-cultural measure of quality of life for use in health and health care. Discussion The theoretical and philosophical basis of the WHOQOL instrument is outlined as it evolved throughout the design and adjustment of a reflexive methodology that places an assessment of the users' views at the centre of health care. The stages of research are further expanded and explained in recounting the scientific experience of this unique collaboration. The WHOQOL is available in 40 countries and most majority languages. Adaptations exist for assessing particular conditions, e.g. spirituality, religion and personal beliefs.