Purpose <p>This study explores the psychosocial impact of breast cancer (BC) support groups on survivorship and treatment decision-making among women in Harar, Ethiopia. It examines the influence of cultural, social, and economic factors on treatment decisions and assesses the effectiveness of support groups in addressing these challenges.</p> Methods <p>A community-based case study used semi-structured, in-depth interviews and focus group discussions. Participants included women attending BC support groups and key informants, including healthcare providers, caregivers, and spiritual leaders. Data were collected at the Hiwot Fana Cancer Treatment Center and were analyzed thematically using an inductive approach to identify key themes.</p> Results <p>The study highlighted significant barriers to timely BC treatment, including cultural stigma, financial constraints, reliance on alternative medicine, and limited healthcare infrastructure. Support groups were pivotal in improving emotional and psychological well-being, fostering a sense of community, and influencing treatment decision-making. Participants reported increased awareness, reduced stigma, and enhanced community advocacy.</p> Conclusions <p>BC support groups in Harar address critical gaps in cancer care by providing psychosocial support and mitigating barriers to treatment. These groups also serve as platforms for community education and advocacy, promoting early detection and modern treatment practices.</p> Implications for cancer survivors <p>Support groups empower BC survivors by improving emotional resilience, facilitating informed treatment decisions, and fostering a sense of belonging. They also help reduce stigma and build supportive community networks essential for long-term survivorship in low-resource settings. Expanding access to such groups could significantly enhance cancer care outcomes in Ethiopia and similar contexts.</p>