<p>This study aimed to explore the spiritual needs of elderly patients with chronic wounds in China and to provide evidence for developing targeted nursing interventions. A descriptive qualitative design was employed. From February to June 2023, 15 elderly patients with chronic wounds were recruited from a tertiary hospital in Wuxi, China, using purposive sampling, and semi-structured interviews were conducted. Data were analyzed using conventional content analysis. Four major themes were identified: the need for role adaptation and self-worth realization, the need for peace and self-reconciliation, the need for emotional connection and support, and the need for control and hope. These findings indicate that the spiritual needs of elderly patients with chronic wounds are multidimensional and closely intertwined with their physical condition, psychological status, and sociocultural context. Targeted, patient-centered spiritual care strategies, including multidisciplinary collaboration and the use of tele-nursing, may help improve spiritual well-being and overall quality of life.</p>