© 2018 Elsevier Inc. Objectives: To describe pediatric palliative care (PPC) in pediatric oncology, the importance of PPC for pediatric oncology patients, disparities within pediatric palliative oncology, innovative strategies for improving PPC access in underserved populations, and implications for oncology nursing practice. Data Sources: Published pediatric oncology and palliative peer-reviewed articles and guidance documents. Conclusion: Disparities exist within pediatric palliative oncology. There is much work needed to improve the reach and quality of PPC for pediatric oncology patients, especially those from underserved populations. Implications for Nursing Practice: Nurses serve a critical role in advocating for PPC for seriously ill pediatric cancer patients and their families.