Objective To explore the implementation effect of advance care planning (ACP) intervention based on shared decision-making theory in advanced cancer patients.Methods One hundred and seven advanced cancer patients were divided into two groups according to the time of admission. Fifty-four patients admitted in May to July 2023 were used as the control group, and 53 patients admitted in August to October 2023 were used as the intervention group. The control group received routine nursing intervention, while the intervention group additionally received an ACP intervention program based on shared decision-making theory. After 4 weeks of intervention, the two groups were compared in terms of ACP acceptance, satisfaction with decision-making participation, and dignity scores. Results The total score of patient′s ACP acceptance, scores in various dimensions, and the score of decision participation satisfaction in the intervention group were significantly higher than those in the control group, while the total score of dignity was significantly lower than that in the control group (all P<0.05). Conclusion Implementation of the ACP intervention based on shared decision-making theory for advanced cancer patients can increase their acceptance of ACP, improve their satisfaction with decision-making participation, and maintain the dignity of terminally ill patients.