Objective To understand the real self-management experiences in patients with head and neck neoplasia, and to provide a reference for constructing an effective self-management intervention programme.Methods A descriptive qualitative study was designed, a semi-structured interview outline was developed based on the Integrated Theory of Health Behavior Change, literature review and expert consultation.Then in-depth interviews with 15 patients with head and neck neoplasia were conducted.Directed content analysis was used to dissect and refine themes.Results Three themes and 9 sub-themes were summarized:health knowledge and beliefs (lack of disease-related knowledge, incomplete self-management perceptions, and variations in self-efficacy), self-regulation skills and competencies (symptom and toxicity management, negative emotion regulation ability, and management of work and daily life), and social support needs (healthcare worker support needs, family and friend support and needs, and financial support needs).Conclusion The barriers to self-management behaviour in patients with head and neck neoplasia are complex.Nursing personnel can help patients to improve their self-management ability based on patients′ needs through strengthening self-management knowledge education, self-management skill training and mobilizing the social support system.