Objective To identify the influencing factors of dyadic coping in young and middle-aged couples facing gynecologic cancer.Methods A descriptive qualitative study was conducted based on semi-structured interviews with 12 pairs of young and middle-aged couples facing gynecologic cancer.Interview data were analyzed using thematic analysis.Results Four themes （intrapersonal characteristics, interpersonal interactions, support systems, and sociocultural environment） and eleven sub-themes were revealed.Conclusion This study highlighted multilevel influencing factors of dyadic coping in young and middle-aged couples facing gynecologic cancer.Couple-based interventions should be designed to facilitate cancer adaptation.