Objective To investigate the practice of advance care planning(ACP) among medical staff working in elder care facilities, and analyze the influencing factors and countermeasures. Methods Through convenient sampling method, 223 medical staffers working in 15 elder care facilities in 9 administrative regions of Chongqing main urban areas were recruited to fill out questionnaires about ACP knowledge, practice and practice hindrance. Results The total score of ACP practice among the medical staffers working in elder care facilities was (10.22±2.19) points, which was at medium level. The average participation rate of ACP practice was 20.1%. The leading factor impeding ACP practice was "the treatment of the dying elderly was usually determined by the views of the family". The total score of ACP knowledge was (20.88±6.33) points, which was below medium level. Overall knowledge of ACP, ACP implementation intention and ACP knowledge scores affected ACP practice of the medical staff (P<0.01 for all). Conclusion ACP practice among medical staff working in elder care facilities is less satisfactory. It is necessary to ramp up the training and publicity of ACP, and formulate strategies according the influencing and hindering factors, so as to smooth implementation of ACP in elder care facilities.