This review examines the current practices, challenges, and advancements of Advance Care Planning (ACP) and Shared Decision-Making (SDM) in clinical settings in Korea. These approaches represent a shift toward patient-centered care, offering patients greater involvement in decisions concerning their treatment, especially for those facing life-limiting illnesses. The Korean context presents unique cultural, legal, and practical factors that influence ACP and SDM’s implementation. This article explores these factors, recent regulatory developments, and future directions for improving ACP and SDM in Korean healthcare.