Objective To investigate the status of anticipatory grief in spouses of patients with advanced renal cancer, and to analyze the influencing factors. Methods Totally, 209 spouses of hospitalized patients with advanced renal cancer were selected through convenience sampling and surveyed with a general information questionnaire, the Chinese version of Anticipatory Grief Scale, the Perceived Social Support Scale, the Zarit Burden Interview and the Connor-Davidson Resilience Scale. Results The spouses of patients with advanced renal cancer scored （86.02±16.12） points in anticipatory grief.Gender, relapse/metastasis, care burden, psychological resilience and social support were influencing factors of anticipatory grief in this group, accounting for 28.7% of the total variation （all P＜0.05）. Conclusion Anticipatory grief in spouses of patients with advanced renal cancer is at a high level.Medical staff should pay attention to female spouses, spouses of patients with recurrence and metastasis, spouses with insufficient social support, heavy care burden or low psychological resilience, and take effective intervention measures to reduce their anticipatory grief level.