Objective Based on a dyadic perspective, to understand deeply the experiences of spiritual coping in advanced cancer patients and family caregivers, and provide a basis for the formulation family caregiver-cancer patient dyads collaborative spiritual care program. Methods Twelve dyads of patients with advanced cancer and their family caregivers were selected by using purposeive sampling method in the department of TCM oncology, and semi-structured interviews were conducted.Colaizzi analysis and dyadic data analysis method were used to analyze the data. Results Five themes were extracted:accepting the present （accepting the reality, fostering hope, accepting death）, self-transcendence （enlightening life, taking responsibility, loving oneself）, connecting with the outside world （feeling family warmth, seeking spiritual support, being grateful to others）, transcending reality （maintaining normal life, putting hope in faith, getting close to nature）, responding negatively （questioning fate, losing expectations）. Conclusion Patients with advanced cancer and family caregivers mostly adopted positive spiritual coping ways in the process of dea-ling with cancer.The spiritual coping experiences of them were similar and mutually influencing each other.Medical staff should treat patients and caregivers as a whole, formulate and implement targeted spiritual care programs, in an effort to improve dyadic spiritual health and quality of life.