This study used a questionnaire survey to evaluate the long-term quality of life (QOL) in 51 patients who underwent total gastrectomy. Activities of daily living (ADL) were good in 20, relatively good in 9, relatively poor in 13, and poor in 6 patients. The other 3 patients were treated on an inpatient basis. Of 38 patients who had been employed before surgery, 18 (47%) resumed working. Physically, body weight increased or showed no changes in 38 patients (74%), but decreased in the other 13 patients, of whom 3 showed a 15% or more decrease. Dumping symptoms developed in 13 patients (26%), 2 of whom had a severe condition. Clear decreases in physical strength and mental strength (spiritual energy) were reported by 10 and 8 patients, respectively. Comprehensive QOL was good in 20, slightly poor in 17, and poor in 14 patients. Quality of life was poor in 12 (41%) of the 29 patients with good ADL. The following were suggested as necessary for patients and their families: sufficient preoperative explanation about pathophysiology and nutritional management after total gastrectomy; execution of a continued patient education program until after discharge; and explanations in specific terms about cooking methods, nutritional management, exercise therapy, periodic medical checks, and patients' associations using pamphlets and food models to describe daily living of the patients after discharge.