Background <p>Anticipatory grief (AG) exists in family caregivers of advanced cancer patients. Existing studies have paid insufficient attention to family caregivers’ AG in Chinese palliative care (PC) wards, and the association of its influencing factors remains unclear.</p> Purpose <p>To describe current status of AG among advanced cancer patients’ family caregivers in PC wards, to explore factors influencing AG and to analyze their pathways and magnitude.</p> Methods <p>A cross-sectional study investigated the sociodemographic characteristics, AG, caregiver burden, social support and coping of 205 participants. Statistical descriptions, influencing factor exploration and correlation analysis were conducted in SPSS 26.0. AG factors and their paths were analyzed using Amos 26.0.</p> Results <p>The mean AG score of family caregivers was 74.91 ± 12.64, where caregiver burden (37.60 ± 12.52) and social support (39.09 ± 6.69) were moderate, and positive coping (19.70 ± 6.39) was better than negative coping (6.15 ± 4.38). The results of path analysis and mediation model test signified that caregiver burden had a direct and positive association on AG (β = 0.510), social support (β = 0.147), and positive coping (β = 0.144), respectively, that mediated the association between caregiver burden and AG, and the chained mediation role of social support and positive coping was 0.019.</p> Conclusions <p>The AG of advanced cancer patients’ family caregivers in Chinese palliative care was complex and diverse. Social support and positive coping played a chain mediating role in the association of caregiver burden on AG. Family-centered care in different cultural context is imperative to relieve caregiver burden and enhance mental health of family caregivers, and expand the coverage of palliative care and death education could further benefit advanced cancer families’ overall well-being.</p>