Grounded in self-determination theory (SDT), this cross-sectional study tested relations of students’ perceptions of autonomy-supportive and controlling behaviour from teachers in physical education with students’ health-related quality of life (HRQoL), and the potential role of students’ perceived need satisfaction and need frustration as a mediator of these relationships. School students (N = 1031) completed self-report measures of perceived autonomy support, perceived teachers’ controlling behaviour, students’ need satisfaction and need frustration, and HRQoL. Results indicated that students’ perceptions of autonomy support from teachers was positively associated with HRQoL through need satisfaction. Students’ perceptions of controlling behaviour from teachers was negatively related with HRQoL through need frustration. There was no significant association between autonomy support and need frustration, or between controlling behaviour and need satisfaction. Findings provide evidence that perceived autonomy support and controlling behaviour from the teacher in PE contributes to students’ HRQoL through unique pathways.