Advance Directives (AD) in Hong Kong is facilitated under common law framework rather than statutory legislation. A valid and applicable AD should in principle be respected in medical decision making at end of life, or when a patient falls into irreversible coma. The Hospital Authority (HA) promulgated a set of AD Guidance for public hospitals in 2010, and Guidelines on Advance Care Planning in 2019. While gradual adoption of AD is observed, practical difficulties are encountered in clinical practice, and there are views that AD under the common law framework has significant legal uncertainties in its relation to Mental Health Ordinance provision (allowing treatment without consent to mentally incapacitated persons based on best interests principle) and Fire services Ordinance clauses (which require ambulance officers to always put resuscitation and saving life as the eminent duty). In 2019, the Government is considering to consult the public on legislating AD in Hong Kong, to better facilitate choice and care near end of life. This presentation considers the ongoing discussion of key issues in Hong Kong, enabling factors and challenges in future practice.