Objective To integrate the existing qualitative research on experiences of surrogate decision-makers (SDM) in making life support decisions for the critically ill, to explore their common experiences and to provide reference for targeted intervention.Me-thods A systematic search was conducted in databases including China National Knowledge Infrastructure (CNKI), WanFang Database, VIP Database, SinoMed, PubMed, Embase, Web of Science, PsycINFO, and CINAHL for studies regarding the expe-riences of SDM in making life support decisions for the critically ill, from database inception until November 2023.Quality of the included studies was evaluated, and the meta-integration method was used to explain and integrate the research findings.Results A total of 12 articles were included in the study, from which 42 results were extracted and summarized into 11 categories.These categories were further synthesized into four integrated themes:the challenging decision-making process, complex emotional feelings, diverse decision-making needs, and end-of-life care considerations.Conclusion SDM of critically ill patients face multifaceted decision-making challenges.It is recommended that healthcare providers increase attention to SDM, develop comprehensive support strategies, enhance their ability to cope with life support decisions, and ultimately alleviate their emotional stress.