Objective To understand the experiences and demands of patients with gynecological malignancies during the admission preparation period for elective surgeries, and to provide references for implementing pre-admission management. Methods A descriptive qualitative study was adopted and a purposive sampling method was used to conduct semi-structured interviews among 12 patients with gynecological malignancies and 10 medical staff. The interview data were analyzed using NVivo12 software. Results A total of six themes were extracted: loss of control and pursuit of hope (disease uncertainty and surgical decision-making dilemmas, trust in medical treatment), heterogeneity of health literacy, complex psychological states (coexistence of positive coping and negative emotional distress), patient role adaptation disorders (female role trauma, role transition disorders), needs during admission transition period (lack of pre-admission nursing services, establishment of admission preparation centers) and high social support needs (desire for professional support, expectation of financial assistance). Conclusion The experiences and demands of gynecological cancer patients during the admission preparation period for elective surgeries need to be further improved and satisfied. Medical staff should focus on pre-admission services for patients, strengthen pre-admission health guidance and provide multi-dimensional social support to enhance their experience.