Abstract Introduction Chronic illness often brings about existential concerns, including fear of death, which can significantly impact individuals’ well-being. The concept of sense of coherence provides a framework for understanding how individuals perceive and cope with stressors, including those associated with chronic illness. Purpose This study investigated the correlation between Sense of Coherence, death anxiety, and chronic illness among Greek patients, aiming to understand how these factors interplay. Methods An electronic survey was distributed to chronic illness patients in Greece. Sense of Coherence was measured using the Sense of Coherence scale, while death anxiety was assessed using the Collett-Leste Fear of Death scale. Various chronic conditions were considered, and demographic data were collected. Results The final sample consisted of 118 participants (female 79.7%; death anxiety score=mean109.2, Sd = 19.2; sense of coherence score=mean55.12, Sd = 13.61). Women and the age group of 58-65 years presented higher death anxiety score followed by the group of 34-41 years. No differences were found between genders in terms of sense of coherence. The highest coherence was manifested in the age group of 50-57 years and the lowest in the age group of 42-49 years. A significant negative correlation was observed between sense of coherence and fear of death (rs(118)= -.299, p < .01). Further correlation tests were performed between axes of coherence, which indicated a stronger negative correlation in two of the three axes of the sense of coherence (Manageability and Meaningfulness) and among all the axes of fear of death, beyond the first, which concerns the loss of one’s own life. Conclusions The study suggests that individuals with a stronger sense of coherence experience lower death anxiety. Understanding these dynamics is crucial for tailored patient interventions and support strategies. Key messages • Gender and age-specific variations exist in how people approach and experience disease and mortality. • Understanding patients’ coping mechanisms and perceptions of illness is important in disease management.