Introduction <p>Lung transplantation (LTx) aims to improve the health-related quality of life (HRQoL). We applied the GR-Scale for the first time in patients after LTx due to interstitial lung diseases (ILDs), compared it longitudinally with non-transplanted patients, and evaluated the impact of chronic allograft dysfunction (CLAD) on the HRQoL.</p> Methods <p>In this prospective longitudinal cohort pilot study, we compared HRQoL by utilizing the GR-Scale between non-transplanted patients (<i>n</i> = 32) and transplanted patients (<i>n</i> = 26). In a second step, we compared HRQoL between transplanted patients with (<i>n</i> = 11) and without CLAD (<i>n</i> = 42). A follow-up assessment was conducted after 3 to 6 months.</p> Results <p>Statistically significant differences in HRQoL were observed between patients after LTx and non-transplanted patients, with worse HRQoL in non-transplanted patients, at both baseline (<i>p</i> &lt; 0.001) and follow up (<i>p</i> &lt; 0.001). Furthermore, the GR-Scale found statistically significant worse HRQoL in transplanted patients with CLAD compared to those without, both at baseline (<i>p</i> = 0.014) and follow-up (<i>p</i> = 0.011). Additionally, significant differences were found in the individual items of the GR-Scale, with physical symptoms showing a more pronounced difference than psychological symptoms in both analyses. No significant differences were observed between the groups regarding age and sex.</p> Conclusion <p>Our pilot study suggests that the GR-Scale is an easy-to-use and valuable tool to assess HRQoL in lung transplant recipients providing important additional information for clinical evaluation of this patient population, also longitudinally.</p> Trial registration <p>Our study was retrospectively registered in the German Clinical Trial Register (DRKS) on 02.11.2022 (DRKS-ID: DRKS00030599).</p>