Objective: This study aimed to explore the efficacy of hospice care for terminally ill emergency patients in the COVID-19 context. Methods: A total of 86 terminally ill emergency patients at the authors' hospital from February 2020 to October 2020 were included in this study, they were randomly allocated into a control (n = 42) and an intervention (n = 44) group, respectively. The control group received routine nursing care, and the intervention group received hospice care. Results: Following treatment, the survival time (as the primary outcome) in the intervention group was longer than in the control group (P < 0.05). Distress thermometer and psychological pain-related factor scores for the intervention group were lower than those of the control group (P < 0.001 for both). The comfort scores of all dimensions in the intervention group were higher than in the control group (P < 0.05). The scores for survival puzzle, symptom distress, independence, and mental well-being in all dimensions related to a sense of dignity were lower in the intervention than in the control group (P < 0.05 for all). The intervention group's yield, avoidance, and total scores were lower than in the control group, whereas the face score was higher than in the control group (P < 0.05 for all). Conclusion: In the current COVID-19 context, the telehealth (psychological, physical, online remote support, critical illness communication, and death education) approach adopted by the Aiming care team for terminally ill emergency patients and other aspects of peace care could help improve the physical and mental health of patients. Hospice care can minimise the physical and psychological pain of terminally ill patients in the emergency department and assist them in their final stage of life by providing a calming and comfortable environment.