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Patients with advanced cancer frequently experience distressing physical symptoms, which cause significant suffering for both patients and their families while often proving refractory to standard symptomatic treatments. Furthermore, cancer itself constitutes a profound stressor, with 25%–49% of patients developing existential distress. 1 Although palliative sedation is recognised as an intervention to control refractory symptoms, including those suffering existential distress, it remains underused in China. Internationally, no consensus has been reached regarding the application of palliative sedation for existential distress. We present a case of a patient with advanced cancer with complex physical symptoms and existential distress managed with palliative sedation, aiming to provide clinical references and facilitate the development of this practice in China.