Objective To evaluate the anesthesia ethics cognition, decision-making capacity self-assessment, and teaching situation of undergraduates major in anesthesia, and to provide reference for improving anesthesia ethics education. Methods From June 2023 to July 2023, a questionnaire survey covered 242 five-year undergraduates from Grade 2017 to 2020 majoring in anesthesiology at Fujian Medical University to understand the cognitive tendencies of anesthesia ethics among students at different learning stages. One-way ANOVA and Chi-square test were used to compare the differences. Results Students′ perceptions of 15 anesthesia ethics items, including always putting patient well-being first (4.50±0.95) and protecting patient privacy information (5.02±0.78), are all positive (4 to<5 ) or strongly positive (5 to 6); The cognitive scores for maintaining patient dignity before and during surgery among students at different learning stages were different [basic, basic clinical, and clinical stage student scores are (4.96±0.75), (5.07±0.86), and (5.14±0.74), respectively, P<0.05]. The decision-making ability of students in the ethical dilemma of anesthesia (3.85±1.01) and legal knowledge (3.57±1.24) were rated as neutral (>3 to <4); The fear of ethical and moral dilemmas in anesthesia among students at different learning stages were different [basic, basic clinical, and clinical stage student scores are (4.29±0.82), (4.49±0.85), and (4.75±0.69), respectively, P<0.05]. 130 students (53.7%) hoped that the school would pay more attention to anesthesia ethics education, while only 57 students (23.6%) believed that ethical decision-making skills had been fully taught. Conclusions The anesthesia ethics cognition of undergraduates is generally satisfactory. Clinical practice could improve anesthesia ethics attainment. Anesthesia ethics education should face ethical maladaptation and cognitive gap, deepen the combination of medicine and humanity education, strengthen the ethical practice and guidance in anesthesia courses, and expanded the ethical content and skill teaching related to clinical practice.