Illness perceptions play a significant role in coping and self‐management behaviors adopted by patients when facing health threats. To understand the illness perceptions of patients with urostomy, we conducted a descriptive qualitative study. An interview guide was formed based on the common‐sense model of self‐regulation(CSM), and 19 patients with urostomy were recruited through maximum variation purposive sampling for in‐depth semi‐structured interviews between January 2024 and June 2024. Five themes emerged from the analysis of the interview data through the thematic analysis method: (1) belief and view of the urostomy; (2) disruption of the usual order of life; (3) psychological burden and stress associated with urostomy management; (4) confusion and misconceptions about urostomy care; (5) coping strategies adopted for dealing with urostomy. Our study revealed the cognitive and emotional representations of patients with urostomy and identified that the coping strategies they adopted are oriented to illness perceptions and that illness perceptions also influence the choice of coping strategies. This study provides healthcare professionals with a deeper and broader understanding of the distinctive perceptions of patients with urostomy.