Objective To evaluate patients’ cognition, attitude and influencing factors of genetic counseling on gynecologic tumor, so as to improve its efficiency and implementation. Methods Patients who visited the Clinic of Genetic Counseling of the Department of Gynecological Oncology, Obstetrics & Gynecology Hospital of Fudan University from Mar. 25, 2020 to Mar. 26, 2021 were enrolled. Based on clinical practice, patient feedback and literature reading, a questionnaire survey was designed to analyze the general information and patients’ cognition and attitude towards genetic counseling. Patients were classified according to their general characteristics to analyze the potential factors affecting their cognition and attitude. Results A total of 104 valid questionnaires were collected. Thirty-six patients (34.6%) “felt well enough” before genetic counseling, patients with malignant tumors were more likely to accept genetic counseling than those with endometrial atypical hyperplasia (P=0.048), and those with radical surgery were more likely to accept genetic counseling than those with fertility-preserving treatment (P=0.008). Other patients had various concerns about genetic counseling, and patients without a past history of cancer were more afraid of detected with gene mutations (P=0.017). Patients from developed areas were more anxious about the potential genetic diseases than those from developing areas (P=0.013). Parous patients were more worried about the increased risk of other tumors than nulliparous women (P=0.008). Seventy-four patients (71.1%) wanted to know whether the disease was hereditary through genetic counseling. Patients with higher education level and with positive family history of cancer wanted to know whether the disease was hereditary more than patients with lower education level (P=0.024) and without family history of cancer (P=0.009). Fifty-two patients (50.0%) wanted to know whether their offspring could be effectively prevented if they had genetic diseases, while patient with higher education level (P=0.002), with fertility-preserving treatment (P=0.018), and with demand of fertility preservation (P=0.003) were more eager to know that. A total of 25 patients had germline pathogenic or suspected pathogenic gene mutations. After genetic counseling, 19 patients (76.0%) understood that screening tests should be done as the risk of cancer in other systems increased, 14 patients (56.0%) agreed early intervention could be taken once gene mutation was reported, 10 patients (40.0%) agreed that preimplantation genetic testing (PGT) could be used for genetic block in patients who wanted to have children, 13 patients (52.0%) agreed that the results of genetic test could indicate the disease prognosis and therapeutic targets for further therapy, and only 7 patients (28.0%) knew the measures for early screening of other systems. Conclusion Education, areas, disease type, treatment, family history of cancer, history of cancer, obstetric history and demand of fertility preservation can affect patients’ attitude towards genetic counseling. However, the understanding of the diseases and the related system screening and family genetic risk management are not satisfying among patients with germline pathogenic or suspected pathogenic gene mutations after a genetic counseling.