Palliative surgery is defined as surgery for symptoms attributable to an advanced or incurable malignancy or symptoms due to malignancy treatment. Palliative surgery is a frequent occurrence at cancer centers and represents almost a quarter of a surgical oncologist’s practice. Common indications for palliative surgical consultation include gastrointestinal obstruction, gastrointestinal bleeding, obstructive jaundice, wound problems, bowel perforation, ascites, and abdominal pain. This chapter will discuss the frequent indications for palliative surgery, management options, surgical interventions, and variables associated with outcome. Keywords: palliative surgery; communication; risk-benefit analysis.