Objective To explore the effect of life-of-hope program intervention on upper limb functional exercise during radiotherapy for middle-aged and elderly breast cancer patients. Methods Totally, 92 middle-aged and elderly patients with breast cancer who were to receive postoperative radiotherapy were randomly divided into two groups. The control group received the routine health education and rehabilitation nursing care, while the intervention group was additionally subjected to life-of-hope program. The upper limb range of motion, quality of life and hope level in the two groups were compared when they discharged. Results The intervention group had significantly better upper limb range of motion, and higher quality of life and hope scores than the controls (P＜0.01 for all). Conclusion Life-of-hope program intervention can enhance the function of upper limbs, improve quality of life and raise hope level in middle-aged and elderly breast cancer patients receiving postoperative radiotherapy.