This chapter describes the importance of spiritually sensitive palliative care for cancer patients. Typical symptoms and ways that patients present with spiritual distress are outlined, alongside clinical approaches to spiritual assessment and the common tools used to assist with this assessment, and the relevant differential diagnoses. The chapter reviews evidence-based psychotherapeutic and complementary therapies that address patients’ spiritual concerns. It discusses the influence of different cultural and religious traditions on decision-making and the unit of care. It considers the professional, legal, ethical, training, and service development issues that arise when clinical programs strive to deliver care that is aligned to be responsive to spiritual needs.