Research on health related Quality of Life (QoL) is valuable in developing health policy, assessing medical treatment outcomes and social sciences. Different QoL measurement instruments reflect different facets, and some QoL assessment tools are culturally insensitive. This study examines the existing WHOQOL-BREF (World Health Organisation Quality of Life) 26-item instrument for its suitability for use in New Zealand studies. It focuses on seeking facets of QoL of particular importance to New Zealand culture upon which New Zealand national items may be constructed and included when using the WHOQOL-BREF in studies in New Zealand. In order to achieve this goal, the project involved four sub-studies: verifying the existing WHOQOL response scale descriptors; conducting focus groups to elicit new areas or facets of QoL peculiar and particular to New Zealanders; examining the stability of the WHOQOL-BREF importance scale test-retest reliability; and conducting a national survey to assess what facets of QoL are most important to New Zealanders upon which national items may be developed and the national importance survey. The verification of response scale showed good correspondence with the standard English WHOQOL version. A total of 46 candidate importance items were generated from 12 focus groups’ discussions. Test/retest reliability revealed that the existing WHOQOL-Importance questionnaire items were more stable over a three week period, better than several of the new candidate importance items. Two thousand questionnaires asking what is important to New Zealand were sent out to the NZ general population and 585 returned. Results revealed that what is important varies across age, gender and health states. Twenty-four national items were developed from the national importance data. The study confirmed that what is considered as important facets of QoL varies within New Zealand and that there are facets that are important to New Zealanders not in the existing WHOQOL-BREF.