Background & Objective: The aging population and the rising prevalence of chronic diseases have made palliative care a necessity for improving individuals' quality of life. Many healthcare professionals do not possess sufficient training and knowledge in this regard. The objective of this study was to assess the attitudes and knowledge of internal medicine residents regarding palliative care. Materials & Methods: A cross-sectional study was performed to assess the knowledge and attitudes of internal medicine residents (N=91) at Tabriz University of Medical Sciences. A validated, structured online questionnaire was used to assess demographic characteristics, palliative care knowledge (30 items), and attitudes (37 items) across four domains. The data analysis was conducted using SPSS version 24, employing both descriptive and inferential statistical methods, including t-tests, ANOVA, and multiple linear regression. Results: The mean knowledge score was 19.66 ± 2.93, and the mean attitude score was 139.47 ± 11.44). Prior training (p = 0.041) and male gender (p = 0.009) showed a significant correlation with higher attitude scores. Knowledge scores had a positive correlation with year of residency (p = 0.033) and a negative correlation with age (p = 0.004). Despite limited knowledge, 67% of participants stated that they needed training on palliative care. Conclusion: Despite favorable attitudes toward palliative care, the lack of knowledge, particularly in conceptual and psychological domains, should be addressed. The findings highlight the necessity of palliative care training in internal medicine residency programs.