<p>Kidney transplant failure and the subsequent return to dialysis constitute a profound biographical disruption that extends beyond physical decline to encompass existential and spiritual challenges. While the impact of graft failure on quality of life has been documented, less is known about how individuals draw on spiritual and religious resources to make sense of this transition. This qualitative study explores how patients reconstruct quality of life following kidney transplant failure, with particular attention to spiritual coping and meaning-making processes. Using a descriptive qualitative design, semi-structured interviews were conducted with 21 adults receiving hemodialysis or peritoneal dialysis after transplant failure in Türkiye. Data were analyzed using reflexive thematic analysis following Braun and Clarke’s approach. Analysis revealed four interrelated themes. Participants described intense emotional distress, uncertainty, and loss. Spirituality functioned both as a source of comfort and as a means of reconstructing meaning, enabling participants to reframe suffering, sustain hope, and renegotiate their sense of self and future. Social and familial support further reinforced these processes. The findings suggest that quality of life after transplant failure is shaped not only by physical and psychosocial factors but also by spiritual beliefs and practices. Integrating spiritual care into clinical settings may enhance holistic, multidisciplinary support for patients undergoing this challenging transition.</p>