Through this multicenter cross‐sectional qualitative descriptive study (four institutions in the Quebec health and social services network, Canada), the authors assessed the decision-making needs of patients who frequently use health care services and who have complex care needs. The results of the study reveal that the decision-making needs of this clientele are numerous, varied and different from those of the general population. Twenty-six decision-making needs grouped under five themes were identified. The most common decisions related to visiting the emergency department, moving to a nursing home, and adhering to a plan or treatment. In addition, new themes such as patients' fear and mistrust of health professionals, differences of opinion between health professionals and health professionals' preconceived opinions of patients were identified. These results should inform future research on the development of a decision support tool for patients with complex primary care needs.