GaN-based 500 nm light-emitting diodes (LEDs) with an air-cavity formed on a laser-drilled hemispherical patterned sapphire substrate (HPSS) were investigated. The cross-section transmission electron microscopy image of the HPSS-LED epilayer indicated that most of the threading dislocations were bent towards the lateral directions. It was found that in InGaN/GaN multiple quantum wells (MQWs) of HPSS-LEDs, there were fewer V-pits and lower surface roughness than those of conventional LEDs which were grown on flat sapphire substrates (FSSs). The high-resolution x-ray diffraction showed that the LED grown on a HPSS has better crystal quality than that grown on a FSS. Compared to FSS-LEDs, the photoluminescence (PL) intensity, the light output power, and the external quantum efficiency at an injected current of 20 mA for the HPSS-LED were enhanced by 81%, 65%, and 62%, respectively, such enhancements can be attributed to better GaN epitaxial quality and higher light extraction. The slightly peak wavelength blueshift of electroluminescence for the HPSS-LED indicated that the quantum confined Stark effect in the InGaN/GaN MQWs has been reduced. Furthermore, it was found that the far-field radiation patterns of the HPSS-LED have smaller view angles than that of the FSS-LED. In addition, the scanning near field optical microscope results revealed that the area above the air-cavity has a larger PL intensity than that without an air-cavity, and the closer to the middle of the air-cavity the stronger the PL intensity. These nano-light distribution findings were in good agreement with the simulation results obtained by the finite difference time domain method.