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Background The sibling support service provides emotional and psychological support to siblings of children accessing the hospice services. A disproportionately high number are siblings of palliative oncology patients, particularly in bereavement support. This disparity warrants quantification and further investigation into contributing factors.Aim This study aims to explore why siblings of palliative oncology patients are overrepresented in the bereavement sibling support service. We seek to examine the unique factors contributing to this pattern and better understand how the experiences of these families differ from those with siblings affected by other life-limiting conditions.Method A retrospective analysis of data from the sibling support service will be conducted, comparing the proportion of oncology siblings to those with siblings suffering from other life-limiting conditions. Data was drawn from service records, focusing on age, diagnosis, duration of the palliative care journey, and the timing of referrals.Results While 30.7% of all service users are oncology siblings, only 6.8% have a living sibling with an oncology diagnosis, compared to 54.4% of bereaved siblings. We anticipate that the higher representation of oncology siblings is linked to factors such as the expedited nature of the palliative oncology journey and heightened recognition of the emotional impact on siblings. Preliminary findings suggest that cancer, as the leading cause of death in 1–14-year-olds (Nomis. Mortality statistics – underlying cause, sex and age. Office for National Statistics [internet]) may lead to more immediate referrals for bereavement support. Given that hospice oncology referrals mostly occur after treatment options are exhausted, the time from referral to death is typically shorter for this cohort.Conclusion The disproportionate number of oncology-related bereavement referrals to the hospice’s sibling service reflects the abrupt onset, rapid progression post-referral, and profoundly destabilising impact of paediatric oncology on families, compounded by its higher mortality rate. Understanding the overrepresentation of oncology siblings helps refine targeted support and better address their unique needs.