Despite medical advances, cancer remains the leading cause of death by disease in children. Brain tumors are the second most common cause of cancer in children after leukemia, representing 25% of pediatric cancers. The overall survival rate is about 50% with extremes ranging from less than 5% to more than 90% depending on the histological type of brain tumor. The end of life of children with a brain tumor is marked by the possibility of discomfort symptoms, painful or not, and by a progressive neurological deterioration, which makes the management of these children complex for both families and health professionals. Over the last decade, the concept of palliative care has been increasingly integrated into pediatric onco-hematology services with the primary objective of better symptom control in a global approach to the child and his or her family in order to aim at a better quality of life.