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Pain is a distressing symptom having biological, psychological, and social consequences. A large number of cancer patients are in advanced stages of the disease and for these patients the only positive and realistic option is pain management and palliative care. These patients have complex needs that have to be taken care of in order to improve the quality of life of such patients and their family members. Surgical treatment along with chemotherapy and radiotherapy is the mainstay for the treatment of cancer, but these modalities also have limitations. The main aim behind palliative care is to allay the sufferings of a terminally ill patient by responding to pain using multimodal analgesia including opioids. According to WHO step ladder, other symptoms like breathlessness, fatigue, delirium etc., are also needed to be managed adequately along with psychosocial and spiritual support. Along with it patients and his family members should be well explained that palliative care is a multidimensional approach directed to the best possible care for that stage of their illness, which may not be curative in nature. There are multiple obstacles in the growth of palliative care in India. Nonetheless we have overcome many such hurdles and there has been a noticeable change regarding palliative care in the mindset of health care providers in the last 2 decades.