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Introduction Diminished levels of meaning in life can have a range of detrimental effects on cancer patients, including heightened anxiety, depression, psychological distress, reduced quality of life and, in severe cases, even thoughts of suicide. Notably, young and middle-aged cancer patients often exhibit even lower levels of meaning in life compared with their counterparts in other age groups. The primary objective of this study is to formulate a meaning in life intervention programme and assess its efficacy in enhancing the meaning in life and other relevant indicators among young and middle-aged cancer patients.Methods and analysis A prospective, parallel-group randomised controlled trial will be conducted. Eighty-eight young and middle-aged cancer patients will be randomised into either the intervention or control group. The intervention group will receive 4 week, six-session, group-based meaning in life intervention programme, while the control group will receive treatment as usual. The primary outcome is meaning in life, and secondary outcomes are post-traumatic growth and psychological distress. These indicators will be assessed at baseline, on completion of the intervention and again 2 months following its conclusion.Ethics and dissemination The trial has received approval from the Institutional Review Board of Shanghai Proton and Heavy Ion Hospital (2202-53-04-2301A-2310B). The study results will be shared through peer-reviewed journals and conferences.Trial registration number Chinese Clinical Trial Registry, ChiCTR2200060672.