The advent and scale-up of antiretroviral therapy (ART) have transformed HIV/AIDS from a terminal illness to a chronic, manageable condition, significantly improving the life expectancy of people living with HIV/AIDS (PLWHA). However, longer survival alone does not guarantee an improved quality of life (QoL), which has emerged as a critical health outcome encompassing physical, psychological, social, and environmental dimensions. In Nigeria, and specifically in Cross River State where HIV prevalence remains high at 6.1%, the pursuit of optimal QoL for PLWHA faces numerous challenges including poverty, stigma, inadequate healthcare infrastructure, and social inequalities. Community-based support groups have been introduced as an important strategy to address these challenges by providing psychosocial support, promoting treatment adherence, and facilitating access to care and resources. This study examines the role of support group participation in influencing the QoL of PLWHA in Cross River, Nigeria. The findings highlight that active involvement in support groups correlates with improved psychosocial well-being and better health outcomes, suggesting that these groups play a vital role in complementing medical treatment and enhancing overall QoL. Strengthening support group programs and addressing structural barriers remain crucial for improving the lives of PLWHA in resource-limited settings.