The concept of palliative care, well recognized in the adult population, has not been fully implemented in the pediatric population. Yet there is an urgent need to define and provide excellence in end-of-life care for infants and their families. Beneficent end-of-life care for the dying neonate includes efforts directed at comfort care, assistance with end-of-life decision making, and bereavement support. Through research and education, the challenges to implementing neonatal palliative care programs can be overcome. This article describes the components of neonatal palliative care, identifies the challenges associated wiith the implementation of such programs, and proposes strategies for addressing these challenges.