Introduction When the content of an international quality of life instrument is prepared using international literature, a problem might be that the international literature does not validly represent the quality of life (QOL) at a national level. The EQ-HWB is a new ‘Health and Well-Being’ instrument in development, and its items are derived from an international literature review. As the international literature is mostly based on ‘Western’ investigation, one can question whether this literature represents an ‘Eastern’ view on the QOL as well. In this article, we investigated the face validity of the EQ-HWB in China. Methods This research was a part of an international research effort in 6 countries, selecting 36 ‘candidate’ items for EQ-HWB based on a large pool of items identified in an international literature search. In China, patients and caregivers were interviewed face-to-face using a semi-structured qualitative interview about the face validity of these EQ-HWB candidate items. We calculated the rates of reporting problems on each item and grouped items into three groups:1) less than 20%; 2) from 20% to 50%; 3) over 50%. Next, the thematic analysis method was used to in-depth analysed and summarized respondents’ comments. Results The respondents reported less than 20% problems with 17 items, 20% - 50% problems with 15 items, and 4 items with more than 50% problems. The thematic analysis revealed 8 ‘themes’; items were found to be ambiguous (16x); difficult to understand (11x); contained a complex negative expression (10x); examples used seem inappropriate (7x); misleading connotation in Chinese (2x); long and complex (2x); complex response options (1x) and non-colloquial language (1x). Discussion Our research shows that the items of the EQ-HWB still require scrutiny, for instance, to make the items more comprehensible. In only three items (2x misleading connotation and 1x non-colloquial), cultural aspects seem to matter. It is a surprising finding that the face validity did not seem to relate so much to specific cultural aspects in China, despite that much of the item selection was based on international literature, which can be argued to be ‘Western based’. As the EQ-HWB is developed with an international ambition in mind, our finding can be seen as a reassuring finding for its application, notably in China.