Objective To explore the economic toxicity experience of primary liver cancer patients based on the social ecosystem theory, and to provide a reference for the development of targeted intervention measures.Methods Based on the theory of social ecosystem, a descriptive qualitative study was designed.Using purposive sampling, 19 patients with primary liver cancer from three ter-tiary first-class hospitals in Chongqing were selected and semi-structured interviews were conducted, and content analysis was applied to organize and analyze the interview data.Results Three themes and 9 sub-themes were summarized: the microsystems （perceived economic burden, individual physical and mental stress, economic decision-making behavior）, mesosystems （family role conflict, social differentiation of patients, treatment of economic information imbalance, social alienation）, macrosystems （policy implementation and cognitive gap, and interactive influence of economic environment）.Conclusion The economic toxicity experience of patients with primary liver cancer is profoundly influenced by multi-level factors within the social ecosystem.Healthcare professionals need to adopt a multi-faceted approach, optimize microsystem support strategies, strengthen mesosystem collaboration, and promote the improvement of macro policies, thereby comprehensively alleviating patients′ financial burdens, improving economic toxicity experiences.