Quality-Adjusted Life Year (QALY) is widely used in various aspects of health economics and pharmacoeconomics research, and is an important indicator to measure health output. In recent years, its meaning has been iteratively developed with the deepening of QALY-related research. At present, there is no Chinese research that has systematically sorted out the latest progress in the changes in the meaning of QALY in recent years. It aims to fill this research gap. Based on the previous literature and research practice, the research sorts out the changes in the meaning of QALY, and summarizes them as definition extension and empowerment of QALY. The expansion of the meaning of QALY mainly includes the re-enrichment of the definition of health-related QALY and the inclusion of wellbeing. It retraced the sources of the QALY for well-being and compared the strengths of the extending the QALY versus traditional QALY. The definition, measurement methods and advantages of extended QALY are summarized. At the same time, it also discusses the influence of QALY meaning changes on the construction of the utility score system. It is suggested to pay attention to the changes and development of QALY meaning in the future, actively explore the QALY meaning with Chinese characteristics, and use empirical research to analyze the impact of QALY meaning changes on the consistency and rationality of health decision-making.