OBJECTIVE: To investigate the level of family resilience among patients with gynaecologic cancer and explore hope as a mediator between perceptions of illness and family resilience. DESIGN: A cross-sectional study. METHOD: From May to October 2022, researchers used convenience sampling to survey 320 patients with gynaecological cancer at a level 3A hospital in Jinan City. The study instruments included the General Information Questionnaire, Family Hardiness Index, Brief Illness Perception Questionnaire, and Herth Hope Index. SPSS 26.0 was used to analyse the mediation effect of hope. RESULTS: The mean score for family resilience was 55.86 ± 8.62. Illness perception was negatively associated with family resilience, while hope was positively associated with it. Additionally, hope mediated the relationship between illness perception and family resilience. CONCLUSION: There is considerable room for improvement in family resilience among patients with gynaecologic cancer. Interventions aimed at increasing hope can enhance family resilience. IMPACT: Healthcare providers can boost family resilience by fostering hope in patients, thereby promoting effective coping and adaptation to cancer. PATIENT OR PUBLIC CONTRIBUTION: Patients primarily completed the questionnaires, providing insights into the factors that hindered and facilitated the development of family resilience. These findings were communicated to caregivers for further understanding and action.