Objectives To explore the perceptions of patients undergoing percutaneous coronary intervention (PCI) regarding their pre-operative health education. Methods A qualitative study using semi-structured, in-depth interviews was conducted in one cardiology unit in China from July 2019 to December 2019. Purposeful sampling of 17 patients undergoing PCI was interviewed about their perceptions of pre-operative health education. Thematic analysis of the transcribed data was then used to identify the themes. Results Four themes emerged from the data:(a) triple roles of pre-operative education with the categories of relief (reliving fear); burden (leading to stress); and meaningless (changing nothing); (b) family member involvement with the categories of shared responsibility and family members' duty; (c) facilitators in the process of pre-operative health education with the categories of emotional support, plain language and individualized pre-operative education; (d) inhibitors in the process of pre-operative health education with the categories of contradiction and threatening words. Conclusions Pre-operative health education for patients undergoing PCI should be aligned with the individual patients' information-seeking styles and personal differences, emphasizing individualized patient education. Traditional Chinese philosophy should be considered in the practice of pre-operative education for patients undergoing PCI, which emphasizes family member involvement; at the same time, patient empowerment and self-care should also be stressed. In addition, emotional support and plain language from health professionals are important in pre-operative health education for patients undergoing PCI; contradiction should be avoided, and threatening words should be used with caution and with consideration for cultural variations during pre-operative education for patients undergoing PCI.