Based on the core clinical curriculum for higher specialist training in palliative medicine, each case starts with a short vignette, followed by further information or study results, before a series of questions ask for potential diagnoses, actions, or knowledge recall. Answers are accompanied by discussion and suggestions for further reading, enabling readers to gain the necessary skills for confident and competent diagnosis and management. In addition, a selection of non-clinical cases examines other critical areas of frequently engaged expertise for the palliative care physician, exploring themes of advance care planning, resuscitation decisions, ethics, spirituality, and UK law, ensuring broad relevance to anyone looking after those with advanced incurable disease.