Purposes To evaluate the reliability and validity of a Korean version of the Functional Assessment of Cancer Therapy (FACT)-Vanderbilt Cystectomy Index (VCI) in Korean patients who underwent radical cystectomy (RC) and urinary diversion (UD). Materials and methods We prospectively recruited 108 RC and UD patients who did not have evidence of recurrence from 1994 December to 2015 March. All participants were instructed to complete the Korean FACT-VCI and Short-Form 36-Item Health Survey (SF-36; 1st measurement) and to repeat the Korean FACT-VCI survey one month later (2nd measurement). Statistical analysis included intraclass correlation, Cronbach’s α, time and UD type fixed mixed linear model, principal components analysis, and criterion-related validity with SF-36. Results Korean FACT-VCI was internally consistent (α = 0.802) and had adequate test-retest reliability (interclass correlation = 0.803 and 0.822). The three components model of principal component analysis (cumulative explanatory power, 49.2%) confirmed the internal structural validity of the additional concerns (AC) component of the Korean FACT-VCI, and each component represented the “voiding problem”, “bowel problem”, and “social/functional problem with equivalent explanatory power (19.5%, 15.4%, and 14.4%). Korean FACT-VCI domain scores were generally well correlated with SF-36 domain scores (Pearson correlation coefficients range: 0.286–0.688; all p <0.01). Mixed linear models revealed that the major effect of measurement times was not significant on FACT-VCI (p = 0.589) Conclusions This prospective study confirms the reliability and validation of the Korean FACT-VCI. We expect that this validated tool can be widely utilized in the health-related quality of life studies of Korean patients.