Background: Hypothyroidism is one of the commonest hormonal deficiencies, which is associated with high somatic and psychiatric morbidity. This study was done to assess quality of life (QoL), satisfaction with life and treatment among hypothyroid patients and to correlate level of control, disease duration and free Triiodothyronine (T3)/Thyroxine (T4) ratio to these outcome measures. Methods: A cross-sectional study was applied on 257 hypothyroid patients in Zagazig University hospital from September 2019 to March 2020. All patients filled in thyroid quality of life, satisfaction with life, thyroid symptom, and satisfaction with thyroid treatment questionnaires. Thyroid profile was assessed. Results: Females represented 66.9% with mean age 44.175 years. Regarding Thyroidstimulating hormone (TSH), patients were divided into; uncontrolled, controlled and strictly controlled, which represented 26.5%, 35.8% and 37.7% respectively. Reduced FT3/FT4 prevailed in 40.5%. There were non-significant relation between level of control and QoL; present, hypothyroid dependent, importance rating or total thyrDol 18 scores. There was statistically significant relation between level of control and each of thyroid treatment satisfaction, satisfaction with life score and thyroid symptom scores. There was statistically significant relation between T3/T4 ratio and each of present, total thyrDol 18, thyroid treatment satisfaction, satisfaction with life score and thyroid symptom scores. Athyreotic patients had better QoL and SWLS. Conclusion: Achieving biochemical well-being not essentially means physical wellbeing. TSH alone can render patients biochemically euthyroid yet the patients still suffer. Reduced T3/T4 ratio impaired QoL which pointed to importance of development of management strategy rather than relying only on TSH levels Keywords: Quality, wellbeing, satisfaction