A method and an apparatus for transmitting and receiving a signal based on a spatial parameter in a wireless communication system are disclosed. A method of performing downlink reception by a user equipment (UE) in a wireless communication system according to an embodiment of the present disclosure may comprise: receiving, from a base station, at least one of downlink control information (DCI) or configuration information including a first spatial parameter for uplink transmission; and receiving, from the base station, a downlink channel based on a second spatial parameter based on the first spatial parameter, and based on that the downlink channel is a physical downlink control channel (PDCCH), the second spatial parameter based on the first spatial parameter may be applied for at least one specific CORESET among at least one CORESET configured for the UE.