Background Chemotherapy is one of the main systemic therapies for cancer, but often has significant negative effects on the physical, psychological, emotional, spiritual and social aspects of patients’ lives. Therefore, it is important for nurses to understand patients’ experiences of chemotherapy to provide effective care and management.

Aim To explore Iranian patients’ lived experiences of chemotherapy.

Methods Nine hospital inpatients who had undergone at least one whole course of chemotherapy participated in 14 in-depth, semi-structured interviews. Qualitative data were analysed using a phenomenological approach and themes were generated.

Findings Participants described a broad range of experiences of chemotherapy. They perceived chemotherapy as altering their lives; causing physical and psychosocial suffering; bringing about uncertainty, but also hope; and representing a crucial means of fighting cancer – and, for some, a gift from God.

Conclusion Being aware of the effects of chemotherapy on patients’ lives is important in planning nursing interventions. Nurses need to develop strategies that will moderate the negative effects of chemotherapy, identify patients’ support systems and potential sources of hope, and use these to assist patients in coping with the disease and its treatment.