Objective Gynecologic cancer is associated with long‐term effects that can be both physical and emotional. We examined symptom prevalence and body image disturbance in patients with gynecologic cancer and their association with quality of life. Predictors of clinically‐relevant body image disturbance were examined. Methods A sample of patients in Singapore (n = 104) was assessed for symptom prevalence, quality of life, and body image dissatisfaction. Clinical factors were extracted from medical records. Results The most frequently reported symptoms were fatigue, abdominal bloatedness, weight gain, constipation, hot flashes, and pelvic pain. Approximately one quarter patients reported feeling less physically attractive and dissatisfied with their body. Ordinary least squares regression indicated that symptom prevalence alone predicted physical well‐being, b = −1.09, P < .001, 95% CI, −1.45 to −0.73, and functional well‐being, b = −0.88, P < .001, 95% CI, −1.32 to −0.45. Body image dissatisfaction alone significantly predicted emotional well‐being, b = −0.21, P < .01, 95% CI, −0.35 to −0.06. Younger age was a significant risk factor for clinically‐relevant score of body image distress, OR = 0.95 per year older, 95% CI, 0.92 to 0.99, P = .02. Conclusions Symptom prevalence and body image dissatisfaction were associated with different domains of quality of life. Emotional well‐being of patients was better explained by body image, rather than extent of symptoms experienced. Patients who are younger appear particularly susceptible to body image disturbance.