Background <p>Accurate risk perception promotes patients to identify and prevent disease aggravation. The ambiguity around risk perception of disease aggravation complicates efforts for clinical workers to improve the accuracy of patients’ risk perception. This study aimed to thoroughly describe the risk perception experience of disease aggravation in older patients with non-communicable diseases.</p> Methods <p>This study employed a qualitative descriptive analysis design. Utilising purposive sampling, we recruited 33 Chinese patients from comprehensive hospitals from October to December 2021. Face-to-face semi-structured interviews were conducted to collect qualitative data. Data analysis was carried out using conventional content analysis.</p> Results <p>Four categories emerged: (1) requirement of support from family, (2) emerging symptoms trigger risk perception, (3) concerns of risk factors and adverse outcomes, and (4) reflection improves risk perception of disease aggravation.</p> Conclusions <p>Clinical workers and health cadres may implement supportive measures to improve patients’ risk perception of disease aggravation by facilitating their recognition of family support; enhancing perception of symptoms, risk factors and adverse outcomes; and encouraging reflection of disease management cognition and behaviour.</p> Graphical Abstract <p></p>