Abstract：Objective To analyze the clinical effects of palliative chemotherapy and non-chemotherapy treatment in patients with end-stage tumor. Methods A total of 90 end-stage tumor patients treated at our hospital from December 2020 to December 2021. Based on the subjective wishes of the patients and their families, they were divided into a study group and a control group, with 45 patients in each. The study group underwent palliative chemotherapy, while the control group received non-chemotherapy treatment. The clinical effectiveness of both groups was evaluated.Results The study group showed better scores in emotional distress and quality of life than the control group （t＝12.810, 11.562, 6.898, 9.864, 6.543, 10.442, all P＜0.05）. However,  an overall effectiveness rate, disease control rate, and the incidence of adverse reactions were higher in the study group （χ2＝4.500, 9.360, 4.555, 4.121, 4.727, 4.464, all P＜0.05）. Conclusion Palliative chemotherapy in end-stage tumor patients can improve disease control and quality of life, but it comes with higher medical costs and adverse reactions. Non-chemotherapy treatment, on the other hand, can improve emotional distress. Therefore, treatment plans should be chosen based on the patient or family's wishes.