The significant time older people typically spend at home affects both their level of physical activity and quality of life. This prospective cohort study was designed to identify the effects that living in a high-rise residence retirement community has on physical activity and quality of life in older people with leprosy. The relocation group was comprised of study participants who had relocated voluntarily to a high-rise apartment building. The comparison group was comprised of study participants who had chosen not to relocate to that building. Data were collected using a personal information survey, Modified Baecke's Questionnaire, and the brief version of the World Health Organization Quality of Life assessment (WHOQOL-BREF). The groups were significantly similar in terms of household activities, leisure time activities, total physical activity score, and quality of life physical and social aspects, and significantly different in terms of quality of life overall (F=7.864, p=0.006), psychological (F=5.403, p=0.021) and environmental (F=23.099, p=0.000) aspects. This study indicates that living in a high-rise apartment environment does not decrease physical activity and may promote overall quality of life, and psychological and environmental aspects, in retirement community residents. The findings enhance understanding of the effect of different living environments on physical activity and quality of life. Greater health professional participation in retirement community design to ensure such designs facilitate residents’ health and quality of life is recommended.