Objective To explore the mediating effect of death avoidance on the relationship between knowledge of thanatology and self-exploratory behaviors in death education among medical undergraduates.Methods Among undergraduates at a university of traditional Chinese medicine using the Chinese version of the Death Attitude Profile-Revised (DAP-R), the Thanatology Knowledge Questionnaire, and the Self-Exploration Behavior in Death Education Questionnaire.Results Death avoidance was negatively correlated with both knowledge of thanatology (r = -0.20, P < 0.01) and self-exploratory behaviors in death education (r = -0.15, P < 0.01), while knowledge of thanatology was positively correlated with self-exploration behaviors in death education (r = 0.17, P < 0.01). Knowledge of thanatology had a significant direct effect on self-exploratory behaviors in death education, and also an indirect effect through the mediation of death avoidance (indirect effect value = 0.01), with the mediating effect accounting for 14.24% of the total effect.Conclusion Thanatology Knowledge among medical undergraduates can directly influence self-exploration behaviors in death education, and can also exert an indirect influence through the mediation of death avoidance. Based on these findings, it is recommended that universities construct a multi-dimensional intervention system. This includes optimizing thanatology curriculum design and strengthening practical exposure to clinical death scenarios to enhance students'' knowledge base. Furthermore, targeted interventions such as death exposure therapy (hospice care practice, death experience activities) should be implemented to mitigate death avoidance tendencies. These measures are crucial to break the vicious cycle in which knowledge deficiency fosters death avoidance, which in turn inhibits exploratory behavior, thus ultimately achieving a substantive improvement in self-exploration behaviors within death education.