While great strides have been made in the treatment of pediatric malignancies, a significant proportion of children with cancer will eventually die of their disease – especially in resource-constrained settings. As a patient approaches death, they often experience extensive physical, emotional, psychological, and spiritual suffering along with the suffering of their families. One of the key elements in providing care for these children and their families is effective and compassionate care coordination and communication regarding end-of-life issues. This care coordination and these discussions about end-of-life care require thoughtful efforts in several areas, including (1) assessing goals of care and supporting advance care planning; (2) assessing and supporting psychosocial, emotional, cultural, and spiritual elements of care; (3) providing anticipatory guidance regarding end-of-life symptoms; and (4) preparing for and providing bereavement support. Thoughtful and compassionate communication regarding end-of-life care is a critical skill for any clinician caringEnd-of-life care, coordinationclinician caring for children with cancer.