CONTEXT: The COVID-19 pandemic has forced people to maintain social distance and to refrain from going out. As a result, home-based patients with spinal cord injuries (SCI) are not only less able to go out, but they may have difficulty in easily receiving long-term care services. There are concerns that their health-related quality of life (HRQOL) may have deteriorated. We aimed to clarify the effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI.In June 2020, when the COVID-19 pandemic was finally settling down in Japan, we conducted a mail survey of 266 patients with SCI regarding changes in the frequency of going out, the long-term care services, and their HRQOL due to the COVID-19 pandemic. They had all been discharged from our hospital (Rehabilitation medical center) by 2019, and were expected to be living at home. We received answers from 135 patients about their HRQOL. FINDINGS: Respondent characteristics indicated that many of them were elderly (74.1% were over 60 years of age) and many had cervical SCI (70.5%). Worsened HRQOL since the impact of the COVID-19 pandemic was reported by 40% of respondents. The most commonly reported dimension was pain/discomfort. Significantly, many had been injured comparatively recently and had reduced frequency of going out and receiving home-visit nursing or rehabilitation services than patients whose HRQOL was unchanged. CONCLUSION/ CLINICAL RELEVANCE: This study clarifies the negative effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI. Many respondents had worsened HRQOL, in particular pain/discomfort. It was suggested that the decrease in the frequency of going out may be one of the factors that affected the deterioration of their HRQOL.