To describe the relative importance of 38 facets of quality of life (QOL) to older adults in 22 countries, by gender, age group, and health status. A secondary analysis of data was conducted from the WHOQOL-Old pilot study. Questionnaires were distributed by mail or in person. Independent t-tests for differences between means were calculated between importance scores by genders, age groups, and healthy/unhealthy participants. Hierarchical multiple regression analysis was used to identify which QOL facets explained importance of overall QOL. Of 7,401 older adults from 22 countries (mean 73.1 years), 57.8% were women and 70.1% were 'healthy'. While there are significant differences in the importance of various facets of QOL on the basis of gender, age, and health status, when these variables were controlled in a stepwise multiple regression analysis, the most important QOL facets were having energy, being happy, having well-functioning senses, and being free from pain. It appears that many of the physical aspects of QOL such as energy, freedom from pain, ability to do activities of daily living and to move around are particularly important to older adults. Practitioners should give greater attention to energy, sensory abilities, and pain.