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Aim: To examine the mediating effect of sleep quality on the relationship between lower urinary tract symptoms and health‐related quality of life in women with type‐II diabetes. Design: A cross‐sectional study. Methods: A study questionnaire comprising three valid instruments was used to obtain data about lower urinary tract symptoms, sleep quality and physical and mental component summary health‐related quality of life between July 2017 and December 2018 (n = 343). Pearson's correlation coefficients were estimated initially to examine the relationships between the three variables. Multiple regression models were tested using a regression‐based approach Hayes PROCESS macro for SPSS to examine the significance of proposed mediation effects. Results: Most participants experienced at least one urinary symptom (n = 268, 78.1%). The total number of types of lower urinary tract symptoms experienced by participants was significantly inversely correlated with physical and mental component summary health‐related quality of life, and sleep quality. Participants' sleep quality was significantly correlated with physical and mental component summary health‐related quality of life. The relationships of lower urinary tract symptoms with physical and mental component summary health‐related quality of life were, respectively, fully and partially mediated by sleep quality. Conclusion: Sleep quality played a mediating role on the relationship between lower urinary tract symptoms and health‐related quality of life. Our findings could lead to improvements of diabetes care in nursing and healthcare practices. Impact Understanding the role of sleep quality in the adverse effects of lower urinary tract symptoms on health‐related quality of life contributes to the development and delivery of appropriate strategies to promote optimal health‐related quality of life. We recommended including assessments of lower urinary tract symptoms, sleep and health‐related quality of life in routine diabetes management. Nurses and healthcare professionals should concurrently reduce lower urinary tract symptoms and improve sleep to achieve this population's optimal health‐related quality of life. Patients or public contribution: We recruited a sample of older women with type‐II diabetes at the endocrinology and metabolism outpatient departments of two hospitals. Study participants provided responses on the study questionnaires. The two hospitals provided needed supports (e.g., height/weight scales, suitable places for interview) during the data collection process. [ABSTRACT FROM AUTHOR]