The terminally ill are emerging as a specialized patient population that needs the expanded skills and knowledge of advanced practice nurses. These nurses can follow patients across a variety of settings in an integrated system of health care and over the continuum of living and dying. This paper addresses the concept of palliative care and the advantages of advanced practice nurse leadership in this area. Four major criteria for the establishment of a new advanced practice nursing area (American Nurses Association, 1995) serve as a framework. These criteria are: the area lies within the scope of nursing practice; a documented need exists; there is a body of knowledge upon which to base the practice; and the field of nursing would be diminished if the need were ignored. The author maintains that there is sufficient evidence for the creation of a new role: advanced practice nurse in palliative care.