Objective To determine the effect of music therapy on the quality of life (QOL) of terminal elderly patients with advanced cancer. Methods A total of 155 patients aged over 60 years at terminal stage of advanced cancer were randomly divided into the study group (n＝58) and the control group (n＝97). The patients in both groups received the conventional basic nursing and symptomatic therapies. The patients of study group received music therapy additionally, for 30 to 50min per time, twice per day, 10 times per week, totally 4 consecutive weeks. The self-edited questionnaire survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were employed to assess the QOL of the patients before and after the study. Results After the therapy, the emotional function, cognitive function, social function and the total score of QLQ-C30 of the patients in study group were increased significantly (P＜0.05). Some symptoms such as fatigue, pain, insomnia, nausea and vomiting were getting better (P＜0.05). Conclusion Music therapy is easy, simple and operable in end-of-life care. It can significantly improve the QOL of terminal elderly patients with advanced cancer.