Aims and background: Quality of spiritual life is influenced by emotional structures, cognitive and motivational factors, so the present study aims to provide a conceptual model of quality of spiritual life based on symptoms and emotional schemas with the mediation of perfectionist cognitions of patients with chronic pain. Materials and Methods: This study was a descriptive correlational study. The statistical population included all men and women (30-50 aged) with chronic low back pain referred to pain clinics in Akhtar, Labbafinejad and Imam Hossein (AS) hospitals in Tehran during the year 99-98. The sample included 400 people according to the inclusion criteria. The instruments used in this study are: Mood/Anxiety Symptoms Questionnaire, Short Form of Emotional Schemas, Perfectionist Structures, Short Form Spiritual Quality of Life. Data were analyzed by SPSS25 and LISREL 8. 8 software programs by structural equation modeling. Results: The results showed that the direct path of mood/anxiety Symptoms to increased Emotional Schemas (p<0. 05), and direct path of Emotional Schemas to increased Perfectionism Cognitions (p<0. 05), was significant. Also, indicated that the indirect path mood/anxiety Symptoms to Spiritual Quality of Life through Emotional Schemas and Perfectionism Cognitions was significant (p<0. 01) Conclusion: The findings of this study support the mediating role of Perfectionism Cognitions in the relationship between emotional Symptoms and Emotional Schemas with Spiritual Quality of Life, so the development of therapeutic interventions based on reduced emotional schemas and perfectionism can be useful in improving the quality of spiritual life of patients with chronic pain.