Cognitive and psychological barriers may hamper the practitioner in addressing the needs of gastroenterology patients. Though not an exhaustive summary of current approaches to palliative care, this issue is a point of reference for practicing gastroenterologists seeking guidance for the management of salient problems encountered in palliative care, the goal of which is to relieve suffering and improve quality of life. Palliative care may be the sole aim of care or offered simultaneously with all other medical treatment. Topics covered include the historic and philosophical background of palliative car as well as palliative care's current status in the field of medicine and its affirmation as a durable philosophy of care that is applicable across a wide spectrum of illnesses encountered in the practice of gastroenterology. Basic palliative care skills, such as palliative care assessment, palliative endoscopy, and chronic pain management are discussed. Although much of the material addresses oncologic illness, the principles and many of the interventions covered are applicable to a much wider spectrum of illnesses, such as liver and intestinal failure.