• Gender, employment, marital status, injury area, and facial burns affect QoL. • Patients' simple abilities had the best recovery, improving significantly over time. • Employment and body image showed no significant improvement over three years. • Patients with more severe symptoms had lower QoL and higher risk of PTSD. Nearly 500 people were injured in the dust explosion at the Formosa Fun Coast water park in 2015, making it the accident with the largest number of burn victims in Taiwan. Severe burn injuries are often accompanied by long-term impacts on physical, psychological, social, occupational, and aesthetic wellness. Survivors usually require several years or even decades of medical rehabilitation and psychological counseling, which inevitably affect their quality of life (QoL). The purpose of this study was to assess the changes in the QoL and the risk of posttraumatic stress disorder (PTSD) among the survivors of the 2015 dust explosion at the Formosa Fun Coast water park and discuss the potential influencing factors. Data were collected from the burn victims using a self-administered sociodemographic and injury characteristics questionnaire, the adapted Chinese version of the Burn Specific Health Scale-Brief (ACV BSHS-B), and the Impact of Event Scale for Burns (IESB). IBM-SPSS (Version 21.0) was used for the statistical analysis of the data. A total of 81 patients were enrolled in this study from July 2016 to August 2018. The study results revealed that gender, employment status after the burn injury, marital status, injury area, and the presence of facial burns greatly affected survivors' QoL three years following the injury. Survivors' simple abilities (Mean: 3.91 out of 4 on average, SD:.21) showed the best recovery and improved significantly over time. Employment (Mean: 2.33, SD:.98) and body image (Mean: 1.94, SD:.95) were considered the most influential factors on QoL, with no significant improvement over the three years. Moderate to severe pain, itching, and sleep problems caused by the dust explosion still affected 29.2%, 46.6%, and 58.1% of survivors after three years, respectively. Survivors with more severe symptoms had worse QoL and a higher risk of PTSD. The burn accident affected not only the injured individuals but also their entire families. In order to help injured individuals reintegrate into society and maintain better overall health, our study suggested providing family-based healthcare plans and necessary follow-up visits in a timely manner. [ABSTRACT FROM AUTHOR]