Purpose: The purposes of the study were to examine psychological distress and health-related quality of life (HRQoL) in relocated and nonrelocated survivors aged 60 years and older, and to analyze predictors for psychological distress and HRQoL in older survivors 5 years after the 2008 Sichuan earthquake. Methods: This was a cross-sectional descriptive study with 112 relocated older survivors and 156 nonrelocated older survivors. Our study used a multistage sampling method. The measurements used in the study included self-reporting questionnaire-20, medical outcomes study 36-item short form health survey, and an instrument measuring demographic and disaster-related characteristics. Descriptive and multiple linear regression analysis were performed to determine factors that contributed to psychological distress and HRQoL. Results: The prevalence of psychological distress in relocated group (20.5%) was significantly higher compared to those in nonrelocated group (4.8%). Scores for HRQoL in relocated older survivors was significantly lower than those in nonrelocated older survivors. Relocation from preearthquake residence was the most significant predictor for psychological distress and HRQoL in the total sample. Other predictors were advanced age, lower educational level, the loss of family members during the earthquake, and the presence of chronic illnesses as well as the death of a spouse after the earthquake. Conclusions: Strategies can be designed in postdisaster recovery program, particularly for older survivors at high risk for psychological distress and poor HRQoL. Copyright (C) 2015, Korean Society of Nursing Science. Published by Elsevier. All rights reserved.