Abstract Background Despite being a common intervention to restore sinus rhythm for patients in atrial fibrillation (AF), limited data exists on the impact of electrical cardioversion on quality of life (QoL) outcomes in clinical practice. Methods Prospective cohort study of consecutive AF patients referred for an outpatient electrical cardioversion at two hospitals in Edmonton from 2013-2014. Baseline demographics, clinical characteristics, medications and procedure details were obtained. Quality-of-life was assessed at baseline and 3 months using the global Short-Form health survey (SF-36) and the Atrial Fibrillation Effect on Quality-of-life (AFEQT) questionnaire. Results One hundred patients underwent electrical cardioversion and completed follow-up. The median age was 62 (IQR, 56-68) years, 80% were male; the majority had non-paroxysmal AF (90%) with a mean left ventricular ejection fraction of 50.0% ( + 12.4). At baseline, scores were lower than those reported from healthy individuals across all domains of the SF-36. The overall mean AFEQT score was 55.6 + 24.4, and the domain-specific scores were as follows: symptoms 66.2 + 26.6, daily activities 48.5 + 29.5, treatment concern 57.6 + 25.8, treatment satisfaction 56.7 + 26.1. There were significant improvements in the vast majority of the SF-36 and AFEQT domains for the 51 patients who maintained sinus rhythm at 3 months. Patients who were in AF by 3 months demonstrated improvements in the AFEQT treatment concern score (p=0.02) and SF-36 emotional role value (p <0.01) compared to baseline which may be the result of treatment expectations related to cardioversion. Conclusions There are significant qualify of life benefits for patients who maintain sinus rhythm after electrical cardioversion.