Skilled and compassionate communication with patients and their families is a priority in all areas of clinical practice. This is particularly important in palliative and end of life care, where people may feel frightened and vulnerable and require clear, honest and compassionate communication from healthcare professionals. However, many patients and families have reported dissatisfaction with their interactions with healthcare professionals in end of life care, including a lack of compassion and understanding of their emotional well-being. This article explores the literature on end of life communication with patients and families and discusses how improvements can be made in this area of practice.