To compare the efficacy and side effects of sufentanil and morphine titration for patient-controlled subcutaneous analgesia (PCSA) in severe advanced cancer pain management.A retrospective analysis was performed on the patients who were treated by two cancer centers with PCSA for severe advanced cancer pain at the Fourth Hospital of Hebei Medical University and Baoding No.1 Hospital between 2018 and 2021. These patients were divided into a sufentanil group and a morphine group. The drug dosage of the two groups was recorded. The pain intensity, sleep quality and adverse event rate (AER) were compared and analyzed between the two groups.PCSA was successful in 95.2% (120/126) of the patients. In all cases, titration was successful within 24 hour, followed by oral administration of sustained-release opioid medications at 208.4 ±75.1 mg in the sufentanil group and at 207.9±66.3 mg in the morphine group. There was a significant difference in pain intensity and sleep quality before and after titration (P <0.05). Both groups exhibited a decline in their heart rates during titration. Compared with the baselines before titration, the mean heart rates were significantly reduced in both groups (P <0.05). The sufentanil group had an AER lower than that of the morphine group.Short-term use of sufentanil supports PCSA for patients with severe advanced cancer pain can achieve effective and rapid pain management, it is worth clinical implementation and application.Copyright: © Pakistan Journal of Medical Sciences.