Background Health-related quality of life (HR-QOL) outcomes provide a measure of a patient’s functional, physical, and emotional health but there is a gap in research concerning emergency laparotomies (EL). This study aims to assess the impacts of EL on HR-QOL. Methods HR-QOL outcomes were assessed in patients who had an EL between February 2018 to January 2021 using the Short Form 12 version 2 (SF12-v2) and the EQ-5D-5L surveys. Pre-operative scores were collected retrospectively and compared to post-operative scores. Results 116 EL patients completed the surveys. Median survey follow-up time was 336.5 days (IQR: 264 – 497 days). SF12-v2 T scores improved for Bodily pain (p < 0.001) and General health (p = 0.003) domains and decreased for Physical functioning (p = 0.007). All five dimensions of the EQ-5D-5L showed no statistically significant difference. Median difference in EQ index scores after EL was 0.053 (p = 0.039), and EQ-VAS general health score improved by 9.3 points (95% CI: 4.6 – 14.0, p < 0.001). Conclusions The SF12-V2 and EQ-5D-5L are useful instruments for monitoring health outcomes in EL patients. Despite being a major operation, HR-QOL is largely unchanged after an EL. Implying that long-term morbidity, from a patient’s perspective, is likely to return to baseline after an EL. This can be vital information for patients and their families when deciding if they want an operation. However, further larger-scale multi-centre studies would be required to support this. Monitoring improvement in patients’ HR-QOL results provides a measure of the efficacy of treatment and the quality of surgical service delivery.