OBJECTIVE: To determine whether there are differences in the foot-specific and general health-related quality of life (HRQOL) of people with and without first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS: The foot-specific and general HRQOL of 43 participants (mean ± SD age 50.0 ± 10.8 years) with symptomatic radiographically confirmed first MTP joint OA (case group) was compared to an age-, sex-, and body mass index-matched control group. Foot-specific HRQOL was assessed using the Foot Health Status Questionnaire (FHSQ) and general HRQOL was assessed using the Short Form 36 (SF-36) questionnaire. Both questionnaires are validated instruments with 0-100-point domains. RESULTS: All domains of the FHSQ were significantly lower in the case group (mean ± SD foot pain 55.5 ± 22.3 versus 93.0 ± 7.8, foot function 73.8 ± 20.9 versus 96.9 ± 11.5, footwear 39.1 ± 28.7 versus 76.6 ± 27.0, and general foot health 50.2 ± 27.0 versus 89.7 ± 16.0). Further, the SF-36 physical functioning domain was significantly lower (mean ± SD 82.8 ± 14.7 versus 95.2 ± 6.3) in the case group. CONCLUSION: People with first MTP joint OA experience more foot pain, have greater difficulty performing functional weight-bearing activities, find it more difficult to obtain suitable footwear, and perceive their feet to be in a poorer state of health. Additionally, people with symptomatic first MTP joint OA have greater difficulty performing a broad range of physical tasks and activities.