Objective To integrate the qualitative research findings on the lived experience and needs of children and adolescents with cancer in the terminal stage of their lives, and to provide reference for better palliative care practices. MethodsA systematic search of both international and domestic data sources was conducted for qualitative studies on the experiences and needs of children and adolescents with cancer in the terminal stage of their lives, from the inception of each database until 1 April 2023. The Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research was used to evaluate the methodological quality of the included literature. Then a meta aggregation methodology was used to synthesize thequalitative studies.ResultsEight studies met eligibility criteria, all of which were rated as B quality. From these studies, 40 study findings were extracted and categorized into seven new categories. Then three main themes were identified: children and adolescents with cancer suffer from physical and psychological distress in the terminal stage; they actively cope with the disease, and experience positive psychological changes and personal growth; and they desire for a normal life and social support. ConclusionChildren and adolescents with cancer undergo both negative and positive experiences in the terminal stage of life, and their needs show age related differences. Healthcare professionals need to pay attention to the experiences and needs of these patients during the terminal stage, and provide psychological counseling and necessary support to improve their quality of life during this challenging period.