Objective To analyze the development trajectory and its influencing factors of palliative performance in middle- and late-stage lung cancer patients, so as to provide a reference for terminal care. Methods The initial diagnosed middle- and late-stage lung cancer patients undergoing surgery were selected, and their palliative performance were investigated by using the Palliative Performance Scale (PPS) at six time points, one day before the surgery （T1）, one to three days before the first circle chemotherapy （T2）, one to three days of the first circle chemotherapy （T3）, the middle stage of the first circle chemotherapy （T4）, one to three days after the first circle chemotherapy （T5）, and three months after the surgery （T6）.The Latent Growth Curve Mixture Model was used to analyze the development trajectory of palliative performance. Results The PPS level of the middle- and late-stage lung cancer patients was （35.00±6.86）% at T1, （31.05±9.09）% at T2, （29.11±11.47）% at T3, 30.00 （10.00,50.00）% at T4, 30.00 （10.00,50.00）% at T5, and 20.00 （10.00,50.00）% at T6.The development curve of the participants′ palliative perfor-mance was divided into an improvement group （41.13%）,a deterioration group （22.58%） and a severe deterioration group （36.29%）.Multinomial logistic regression analysis showed that, age, TNM stage, personality classification, and self-management were significant influencing factors of palliative performance in lung cancer patients （all P＜0.05）. Conclusion The overall palliative performance of middle- and late-stage lung cancer patients shows a trend of deterioration over time.According to the characte- ristics of PPS at different time points, they can be divided into three trajectory categories:improvement group, deterioration group, and severe deterioration group.Advanced age, unstable emotional personality, and low self-management are risk factors of their palliative performance.Targeted intervention should be conducted according to different development trajectories of palliative performance in middle- and late-stage lung cancer patients, so as to provide them high quality cancer care.