Introduction Long-term pelvic floor symptoms after childbirth may impair women's quality of life. The aim of this study was to assess the prevalence of self-reported pelvic floor symptoms 1 year postpartum in primiparous women by degree of perineal tear, with a focus on minor and major second-degree tears, and their association with quality of life.Material and Methods This prospective cohort study was based on data collected within a randomized controlled trial (the Oneplus trial). Women in the trial who had a vaginal birth and responded to a 1-year postpartum follow-up questionnaire were included. Data were collected between January 2020 and May 2021. The main outcome measures were pelvic floor symptoms assessed using the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), and study-specific items related to suturing and perceived body image. Associations between type of perineal tear and pelvic floor symptoms and their impact on quality of life were examined using generalized linear models, estimating adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Trial registration: ClinicalTrials.gov, NCT03770962.Results The cohort consisted of 1911 primiparous women. Among the tear categories investigated, major second-degree tears were the most common (30.4%), followed by minor second-degree tears (18.4%), episiotomy (9.8%), and obstetric anal sphincter injury (OASI) (5.3%). PFD symptoms were reported by 31.4-51.5% of the women. Women with OASI had an increased risk of colorectal-anal distress compared with those with no tear or a first-degree tear (aRR 1.56, 95% CI 1.24-1.96). No associations were observed between minor or major second-degree tears and pelvic floor symptoms. Increasing tear severity was associated with a higher likelihood of perceiving the vagina as narrow. No differences between tear categories were observed regarding impact on quality of life. Episiotomy was associated with a negative body image related to vaginal symptoms (aRR 1.45, 95% CI 1.03-1.99).Conclusions Pelvic floor symptoms and their impact on quality of life were common 1 year postpartum, irrespective of perineal tear category. Minor and major second-degree tears were not associated with an increased risk of pelvic floor dysfunction or reduced quality of life.