Objective To systematically integrate the qualitative research on fertility preservation (FP) decision-making experience of cancer patients, and to provide evidence-based basis for assisting cancer patients to make decisions and improve existing decision support systems. Methods Qualitative studies on FP decisions of cancer patients were retrieved through computer-assisted search in PubMed, EMbase, the Cochrane Library, CINAHL, Web of Science, PsycINFO, Scopus, CNKI, Wanfang Database and VIP database.The publication date of the studies was limited to the period from the establishment of the database to August 2022.The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies.The results were synthesized by using meta-aggregative approach. Results A total of 18 studies were included, and 67 research results were extracted.Similar results were summarized into 7 new categories, which converged to form 3 integrated results:the difficult trade-off between FP risk and benefit, complex psychological processes under urgent decisions-making, interference in the decision-making process. Conclusion Medical staff and related health institutions should pay attention to the psychological experience of cancer patients in FP decision-making, optimize decision-making procedures, and develop decision-making aids, so as to help patients to complete decision-making.