Background Health-related quality of life (HRQoL) measures are being used in increasingly diverse populations. However, there have no known studies to date to examine the associations between perceived environmental pollution and HRQoL in a Chinese adult population. This study aimed to report the associations between air, water, noise pollution and HRQoL among Chinese populations.Methods A cross-sectional survey data was used from East Asian Social Survey 2010 with a sample of 3866 Chinese populations in environmental pollution. HRQoL was computed by SF-12 and reflected by physical and mental component summary score (PCS & MCS). Ordinary least regression analyses were used to examine associations between perceived environmental pollution and PCS and MCS scores. Models in SPSS PROCESS were selected to demonstrate the moderating and mediating effects.Results Only considering one pollutant, perceived air pollution and perceived water pollution had significant associations with PCS and MCS scores. Perceived noise pollution had significant associations with PCS scores. Perceived air×noise, air×water, noise×water, and air×noise×water pollution had significant associations with PCS and MCS scores. Conditional (moderated) mediation showed that there were no moderating effects and mediating effects of perceived one pollutant on another pollutant.Conclusions Co-occurring perceived environmental pollution were mainly associated with progressive increase in PCS and MCS scores among the Chinese adult population. These results suggested that some effective policies should be carried out to improve environmental quality across Chinese adult population.