Along with depression and anxiety, delirium is one of the most common clinical conditions in palliative care settings for which psychiatry may be consulted. Delirium may be the result of underlying medical or physiological conditions and/or can be medication-induced. It presents as cognitive changes, perceptual disturbances, and behavioral agitation and is often misdiagnosed or under-recognized as a result. This presentation provides guidance on how to identify and recognize delirium in patients nearing the end of life and recommend appropriate management