This study examined the effects of good death awareness and knowledge of advance directives on attitudes toward advance directives in middle-aged adult women. Data was collected from May 10 to August 30, 2022, for 154 adult women aged 40 to 64 living in Gyeonggi-do and Chungcheongnam-do. As a result of the analysis, good death awareness was 50.29±7.92 points, knowledge and attitude for advance directives were 9.24±3.16 points and 42.22±3.92 points. Good death awareness of middle-aged adult women and the knowledge(r=.34, p<.01) and attitude(r=.42, p<.01) toward advance directives were both positively correlated, and Good death awareness and the knowledge of advance directives explained 19.1% of middle-aged adult women's attitudes toward advance directives. Based on the results of this study, strategies are needed to improve attitudes toward advance directives for middle-aged adult women, and the development and provision of various educational programs to increase knowledge of good death and advance directives are required.