Aims and objectives. The aim of the study was to investigate the quality of life and related factors among older people who are in pain and in need of help to manage daily living. Background. To intervene against the low quality of life in nursing care knowledge about factors affecting it is needed and this is especially important for vulnerable people such as those who suffer from pain and who are in need of help to manage daily living. Methods. Five hundred and twenty-six people, aged 75–102 years participated in this study. Results. Those in pain reported a significantly higher degree of all complaints and lower quality of life in all measures compared with those not in pain. Overall quality of life was associated with mobility problems, sleeping problems and depressed mood, while health-related quality of life was associated with living in special accommodations, walking problems, mobility problems and fatigue. Conclusions. Those in need of help to manage daily living and in pain seem to be at higher risk of lowered quality of life than those not in pain and the lower quality of life among those in pain is probably caused by the complex of complaints rather than pain per se. Relevance to clinical practice. Daily nursing care should identify and treat the complex of complaints related to pain as well as pain itself, to improve everyday life and quality of life for older people in pain.