Although the knowledge about children suffering from incurable diseases, especially malignancies, is very difficult, despite advances in treatment, some conditions are still incurable. The pediatric population, due to its developmental characteristics, requires more specific care compared to adults. Pediatric palliative care encompasses not only the period of the child's illness but also the period after the child's death, which is extremely painful for parents and family members. The role of a pediatric palliative care nurse is one of the most important in the multidisciplinary team. Since they spend the most time with the child, it is crucial that they are highly educated in this field in order to provide the highest level of quality care. According to the child's developmental age, it is necessary to explain the circumstances they are in to prevent additional stress, which requires nurses to have developed specific skills. Given that malignant disease, its treatment, and the potential end of the child's life are very stressful periods for the entire family, a nurse needs to have well-developed communication skills combined with empathy in order to help cope with the weight of the child's illness, provide necessary information, and give advice. That is why a nurse has an important role in supporting parents throughout all phases of pediatric palliative care, as well as in the grieving process. This paper provides the fundamental determinants of palliative care with a specific focus on the pediatric population affected by malignant diseases. It describes the most common malignant diseases in children, the reactions of the child and parents to malignant disease, the occurrence of unpleasant symptoms in the child with a particular emphasis on pain. Special emphasis is placed on improving the quality of life, communication with the child and parents, support during the duration of care, respite care, and support in the grieving process.