Objective To explore the core content and needs of surgical patients′ participation in perioperative safety, and to provide a reference for patient participation in perioperative safety management. Methods Using descriptive qualitative research method, semi-structured in-depth interviews were conducted with 14 surgical patients, 10 family members and 12 clinical medical staff.Content analysis combined with NVivo 12.0 software was adopted for data coding, analysis and theme extraction. Results A total of 7 primary themes and 19 sub-themes were extracted, including participation in in-hospital safety risk prevention and control, medication safety participation, active acquisition of disease and treatment information before surgery, participation in routine preoperative preparation, involvement in pre-anesthesia safety verification, participation in postoperative safety management, and standar-dized discharge guidance and home risk management. Conclusion The content and needs of surgical patients′ perioperative safety participation are multi-dimensional and stage-specific.It is recommended to establish a doctor-patient collaborative participation mechanism, and promote the effective transformation of patients′ participation intention into behavior via institutionalized information sharing platforms, standardized participation pathways and differentiated educational intervention strategies.