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Background Virtual reality (VR) is increasingly used in healthcare, including palliative care, as a non-pharmacological intervention that offers minimal side effects (Moon, Henstridge-Blows, Sprecher, et al. BMJ Oncol. 2023 Dec 18;2(1):e000160). The ‘Ambitions for palliative and end of life care’ (National Palliative and End of Life Care Partnership, 2021) emphasize comfort, wellbeing, and relief from distress. Although VR equipment is available in the hospice where the author works, its use remains limited. This work aims to explore VR’s potential in end-of-life care and assess whether it is being utilized effectively.Aim To review the evidence on the benefits and challenges of using VR in hospice settings to improve patient wellbeing at end-of-life.Method A literature review was conducted by a hospice staff nurse as part of a palliative care course, analysing current research on VR in this context.Results Recent studies indicate VR can reduce symptoms and enhance wellbeing for oncology and palliative patients, with a patient satisfaction rate of 83.6%. Side effects, experienced by 25.8% of patients, included nausea, headache, and visual strain, but no long-term adverse effects were reported (Moon, Henstridge-Blows, Sprecher, et al. BMJ Oncol. 2023 Dec 18;2(1):e000160). Patients and clinicians noted significant reductions in pain, anxiety, and overall distress.VR also shows promise in addressing ‘total pain’ and alleviating existential suffering at end-of-life (Guenther, Görlich, Bernhardt, et al. BMC Palliat Care. 2022 Oct 5;21(1):169). Personalised VR experiences, such as virtual visits to patients’ homes, have been found more effective, though ethical considerations around privacy are important (Guertin-Lahoud, Coursaris, Sénécal, et al. Cyberpsychol Behav Soc Netw. 2023;26(4):263-272). Overall, research supports VR as a valuable adjunct to pharmacological treatments, with the potential to holistically improve quality of life by addressing physical, emotional, and existential needs.Conclusions Evidence indicates VR benefits symptom management and wellbeing in palliative care, enhancing quality of life. However, further research is needed to understand long-term impacts and develop best practice guidelines. Establishing policies, frameworks, and assessment tools for VR use will facilitate its safe and effective integration into end-of-life care for patients, families, and carers.