We tested the hypothesis that religiosity (ie, seeking God's help, having faith in God, trusting in God, and trying to perceive God's will in the disease) is associated with improved survival in patients with end-stage liver disease who have undergone orthotopic liver transplantation. We studied a group of 179 candidates for liver transplantation who responded to a questionnaire on religiosity during the pretransplant psychological evaluation and underwent transplantation between 2004 and 2007. The demographic data, educational level, employment status, clinical data, and results of the questionnaire were compared with the survival of patients during follow-up, regardless of the cause of any deaths. Factorial analysis of responses to the questionnaire revealed 3 main factors: searching for God (active), waiting for God (passive), and fatalism. The consistency of the matrix was very high (consistency index = 0.92). Eighteen patients died during follow-up (median time = 21 months). In multivariate analysis, only the searching for God factor [hazard ratio (HR) = 2.95, 95% confidence interval (CI) = 1.05-8.32, χ2 = 4.205, P = 0.040] and the posttransplant length of stay in the intensive care unit (HR = 1.05, 95% CI = 1.01-1.08, χ2 = 8.506, P = 0.035) were independently associated with survival, even after adjustments for the waiting for God factor, fatalism, age, sex, marital status, employment, educational level, viral etiology, Child-Pugh score, serum creatinine level, time from the questionnaire to transplantation, donor age, and intraoperative bleeding. Patients who did not present the searching for God factor were younger than those who did, but they had shorter survival times (P = 0.037) and a 3-fold increased relative risk of dying (HR = 3.01, 95% CI = 1.07-8.45). In conclusion, religiosity is associated with prolonged survival in patients undergoing liver transplantation. Liver Transpl, 2010. © 2010 AASLD.