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Study design: Retrospective cohort study using prospectively collected registry data. Objective: The purpose of this study is to evaluate health-related quality of life (HRQOL) and postoperative satisfaction in patients with different histotypes of benign extramedullary spinal tumors (ESTs). Background: Little is known about how different histotypes influence HRQOL and postoperative satisfaction in EST patients. Methods: Patients undergoing primary benign EST surgery at 11 tertiary referral hospitals between 2017-2021 who completed preoperative and 1-year postoperative questionnaires were included. HRQOL assessment included the Physical Component Summary (PCS) and Mental Component Summary (MCS) of Short Form-12, EuroQol 5-dimension, Oswestry/Neck Disability Index (ODI/NDI), and Numeric Rating Scales (NRS) for upper/lower extremities (UEP/LEP) and back pain (BP). Patients who answered “very satisfied”, “satisfied”, or “somewhat satisfied” on a seven-point Likert scale were considered to be satisfied with treatment. Student t-tests or Welch’s t-test were used to compare continuous variables between two groups, and one-way analysis of variance was used to compare outcomes between the three groups of EST histotypes (schwannoma, meningioma, atypical). Categorical variables were compared using the Chi-squared test or Fisher’s exact test. Results: A total of 140 consecutive EST patients were evaluated; 100 (72%) had schwannomas, 30 (21%) had meningiomas, and 10 (7%) had other ESTs. Baseline PCS was significantly worse in patients with meningiomas (P=0.04) and baseline NRS-LEP was significantly worse in patients with schwannomas (P=0.03). However, there were no significant differences in overall postoperative HRQOL or patient satisfaction between histology types. Overall, 121 (86%) patients were satisfied with surgery. In a subgroup analysis comparing intradural schwannomas and meningiomas adjusted for patient demographics and tumor location with inverse probability weighting, schwannoma patients had worse baseline MCS (P=0.03), ODI (P=0.03), NRS-BP (P<.001), and NRS-LEP (P=0.001). Schwannoma patients also had worse postoperative MCS (P=0.03) and NRS-BP (P=0.001), with no significant difference in the percentage of satisfied patients (P=0.30). Conclusions: Patients who underwent primary benign EST resection had a significant improvement in HRQOL postoperatively, and approximately 90% of these patients reported being satisfied with their treatment outcomes one year after surgery. EST patients may exhibit a relatively lower threshold for postoperative satisfaction compared to patients undergoing surgery for degenerative spine conditions. Level of Evidence: 3.