The paper focuses on regional disparities in the quality of life in the Former Yugoslav Republic of Macedonia. It explores the relationship between the quality of life, social exclusion, and policies towards regional and local economic development. The paper is based on a household survey carried out in August 2008 which provides a detailed picture of the situation facing households across regions. Overall, the survey shows that there are large regional disparities in life satisfaction, indicating an important role for regional policy in improving the life experience of people living in the most deprived parts of the country. The paper concludes with a number of recommendations for improving the focus of regional policies to ensure a higher quality of life in the deprived regions of Macedonia.