Summary: This study aimed to compare the effect of three complete denture palatal rugae designs on participants' satisfaction and oral health-related quality of life. The designs included polished, roughened, and open rugae configurations. Results indicated that general satisfaction was similar for polished and roughened designs but significantly lower for the open design. Oral Health Impact Profile scores were worse for the open design compared to polished and roughened designs. Most participants preferred the polished design, while a significant portion chose the roughened design, particularly first-time denture wearers. The open design was not well-received and should be avoided based on negative perceptions.