Objective The aim of this study was to evaluate quality of life after intensity-modulated radiation therapy (IMRT) for anal cancer.Methods Between 2007 and 2011, 63 patients with anal cancer were treated with IMRT and concurrent chemotherapy, and achieved complete response.These patients completed Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and Medical Outcomes Study Sexual Problems Scale (MOSSPS) questionnaires during follow-up visits.Results Thirty-four patients (54 %) answered at least one questionnaire.Among them, the median radiation dose was 54 Gy to the tumor and 45 Gy to the pelvis.The median interval between treatment and the latest questionnaire was 33 months.On the latest questionnaires, the median total FACT-C score was 111, out of maximum (best possible) score 136.The median scores on the Physical, Social/Family, Emotional Functional, and Colorectal subscales were 24, 24, 19,21, and 21, out of maximum (best possible) scores 28, 28, 24,28 and 28, respectively.The median score on the MOS Sexual Problems Scale was 62, out of maximum (worst possible)score 100.Patients with lymph node involvement reported worse total FACT-C scores (p =0.048), as well as worse Social/Family (p =0.026) and Emotional (p =0.032) subscale scores.A history of depression/anxiety was significantly associated with worse Physical (p =0.034) and Emotional (p =0.003) subscale scores.The use of vaginal dilator during treatment significantly improved Social/Family subscale scores (p =0.031).Conclusion Overall quality of life scores were acceptable, but sexual functioning scores were suboptimal after IMRT for anal cancer.