This synthesis study explored the experiences and challenges faced by Emergency Medical Services (EMS) technicians in providing palliative and end-of-life care within the prehospital setting. As EMS increasingly encountered patients with chronic and terminal illnesses, the integration of palliative care principles became vital for improving patient outcomes and family satisfaction. Despite the critical role of EMS, many technicians reported feeling inadequately prepared for the emotional and ethical complexities of end-of-life situations. A systematic literature review identified key themes, including the need for enhanced training, emotional and ethical strain, inconsistent care protocols, and the importance of integrating palliative care into EMS practices. The findings revealed a significant gap in formal training regarding palliative care, which led to varying care delivery and heightened emotional stress among technicians, particularly when family wishes conflicted with medical directives. Additionally, the absence of standardized protocols exacerbated these challenges and hindered effective decision-making. The study recommended the development of structured training programs, the establishment of clear guidelines for palliative care, and the fostering of collaboration between EMS and palliative care specialists. This research underscored the necessity of addressing these gaps to enhance the quality of care provided by EMS technicians and improve the overall well-being of both patients and providers during vulnerable moments in healthcare. Future research should focus on evaluating the effectiveness of training programs and implementing standardized protocols to further support EMS personnel in delivering compassionate end-of-life care. Keywords: Emergency Medical Services (EMS), Palliative Care, End-of-Life Care, Technician Training, Systematic Literature Review