Objective:To explore the cognition of undergraduates on advance directives in a medical universi -ty, and to analyze the affect factors on cognition status of advance directives .Method: Total 594 undergraduates were selected by stratified cluster random sampling and this study conducted a face to face interview using self -de-signed questionnaire .Results: The cognitive status on advance directives was poor .This study found the inde-pendent variables of the gender , religion, the self-reported health, the average monthly living expenditure , the survival time and quality choice and the type of health insurance were the effect factors (P<0.05).Conclusion:the undergraduates′cognitive status on advance directives was poor in this medical university , and we need adopt relevant measures to improve the cognitive of undergraduates on advance directives .