Introduction: Pediatric palliative care includes physical, psychosocial, and spiritual assistance to a sick child and their family in resolving problems during the treatment and until the end. In addition to the medical team and family members, the child should be included in making decisions on the course of the treatment, bearing in mind his/her age. Providing palliative pediatric care and assistance in the process requires the nurse’s high level of specific knowledge, abilities, and skills, as well as highly developed communication skills. Procedures: For this paper, Croatian and foreign literature was used. It is available in the following databases: Scopus, Medline, Embasa. Professional journals and books from the University Library in Osijek were used, as well as literature available in the library of the Faculty of Dental Medicine and Health Osijek. Topic presentation: The medical team that takes care of a child suffering from a malignant disease also takes care of the child’s family members. The family is an active participant and care provider from the conformation of the diagnosis of the malignancy until the very end. The specificity of decision-making refers to the communication between the sick child, family, and team members. The child should be given valid and honest information about the course of the treatment, its consequences, and outcomes, to have the best possible adjustment to the new situation and coping with the disease. Approach to a sick child and family members as well as help in solving problems requires nurse’s constant and continuous education. Conclusion: The complexity of the decision-making and meeting the needs of the child and family in pediatric palliative care requires a holistic approach and continuous education and training of nurses.