Background: Joint disease is a common chronic disease that causes disability and reduces quality of life. The decision- making process regarding total joint replacement (TJR) surgery is a complex process. Purpose: This study was designed to better understand the decision-making process of total joint replacement (TJR) patients. Methods: We used a qualitative research study design to explore the decision-making experience. Eleven patients were interviewed using semi-structured interview guidelines. Interview contents were audio taped and transcribed. Qualitative research was analyzed using content analysis. Results: Results were organized into the following five categories: (1) self-experience (2) accepting fate and restoring meaning to life (3) weighing concerns (4) displaying family functions (5) inexorable riddle. Conclusion: For bone joint replacement patients, surgical treatment decision-making is an important and life-anddeath decision. Treatment decision making is a complex process fraught with many issues that must be carefully weighed and considered. Study results provide a reference for caring for patients with total joint replacement needs, and emphasize the need to decrease patient decision-related distress prior to undergoing treatment.