Health-related quality of life (HRQoL) is a multidimensional indicator of overall health associated with premature mortality. Black men score low on measures of HRQoL, but it is unclear how Black men conceptualize HRQoL and whether there have been efforts to promote HRQoL among these men. The present qualitative study to understand Black men's conceptualization of HRQoL and strategies to improve HRQoL was based in community-based participatory research and the social-ecological model of health. A community advisory board (CAB) was established, and the need for an effort to promote HRQoL promotion among Black men was assessed and supported. A focus group protocol was developed in conjunction with the CAB and a group of barbers. Seven focus groups were conducted consisting of 56 Black men in the Southeastern United States. The mean age of participants was 45 years. Two reviewers coded each focus group. Reliability ranged from 71% to 76%. A thematic analysis was conducted, and the findings were confirmed with the CAB. Three themes emerged: (a) a holistic conceptualization of health that includes spiritual functioning among Black men; (b) a state of HRQoL among Black men predominately marked by mental health concerns, in addition to physical and social health concerns; and (c) multilevel determinants of HRQoL among Black men. This last theme consisted of three subthemes related to community-level, interpersonal, and intrapersonal determinants of HRQoL. Findings from this study can help inform the development of strategies to improve HRQoL and reduce health disparities among Black men. (PsycInfo Database Record (c) 2024 APA, all rights reserved).