This paper assesses the contribution of built cultural heritage to the quality of life in peripheralised small and medium-sized towns (SMTs). While the scientific discourse on peripheralised towns and regions is largely focused on development threats and challenges, this paper highlights heritage as an endogenous resource with the potential to promote a high quality of life in peripheralised towns. A case study covering ten historic towns at the German–Polish border constitutes the basis of the research presented in this paper. Qualitative focus group workshops have been conducted in each town to get detailed insights into the heritage-related quality of life. It appears that under specific conditions, heritage contributes to the quality of life in peripheralised SMTs. This contribution is more pronounced on emotional terms, i.e. regarding meaningful constitutions of place and social cohesion. Practical domains of quality of life related to urban functions or the economy benefit less from the towns’ heritage. It follows that the heritage ressources themselves are no warranty for an enhancement of the quality of life in peripheralised SMTs. Exploiting their potential remains context dependent, and peripheralised SMTs are faced with particular socio-spatial challenges in this regard.