Objective To conduct a scoping review of shared decision-making (SDM) interventions for surrogate decision-makers of ICU patients, to identify core intervention components, aiming to inform future research and clinical practice. Methods Guided by the Joanna Briggs Institute (JBI) scoping review methodology, a systematic search was performed in PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China Biomedical Literature Database, CNKI, and Wanfang, from database inception to December 20, 2024. Study characteristics and interventions were thematically synthesized. Results Fifteen studies (13 RCTs, 2 mixed-methods studies) were included.Nine studies utilized established frameworks including Ottawa Decision Support Framework, Cognitive-Emotional Decision Theory, Family Systems Theory, Social Cognitive Theory, Self-efficacy Theory, and Sense of Coherence Model. Intervention types included decision aids, communication facilitators, multimodal family support, nurse-involved family conferences, and written communication. Interventions were mainly provided in the hospital. Outcome measures included psychological and emotional states, decision-making outcomes, quality and experience of medical services, and patient outcomes. SDM interventions improved decision-making outcomes and enhanced the quality and experience of medical services. Conclusion While the evidence base for ICU SDM interventions is still evolving, their beneficial effects have been preliminarily substantiated. Key priorities for advancing this field include:theoretical framework integration, critical time window selection for interventions, long-term efficacy evaluation, and context-specific adaptation for local practice innovation.