Abstract Background Leadless pacemakers (LesPM) are a new safe alternative technology for pacing the right ventricle. However, not enough information is available on their potential benefits for quality of life (QoL) in patients with LesPM. The purpose of the study was the quality of life comparison of patients with LesPM and conventional pacemakers (ConvPM). Methods The study included patients who underwent implantation of a single-chamber pacemaker from December 2018 to March 2023. We used the SF-36 Questionnaire to assess quality of life at baseline and after 12 and 24 months of follow-up. We also used a questionnaire consisting of 10 specific questions related to the implantation procedure. Results Total of 50 patients were included (25 LesPM; 25 ConvPM). There were no differences in baseline characteristics between groups (LesPM vs. ConvPM), except for age (47.5 vs. 57.3 years; P = 0.012) and diabetes 28% vs. 21%; P = 0.021). Baseline SF-36 did not differ between groups. After 6 months of follow-up, patients in the LesPM group showed significantly higher scores on physical function (47 vs 32; P<0.001), physical role (53 vs 37; P=0.004) and mental health (67 vs 52; P=0.017), even after adjusting for covariates. Pacemaker-related discomfort and physical limitations were significantly lower in the LesPM group. Conclusion LesPM is associated with a better quality of life than ConvPM, both in terms of physical and mental health. Patients who underwent LesPM implantation reported less procedure-related discomfort, physical limitations, and anxiety.