Background: Previous research has shown that the understanding and knowledge about the spiritual needs is not given high priority among nursing staff. During the latest years the body and its functions has controlled the healthcare and the spiritual needs has been placed in the background. All humans have spiritual needs that must be satisfied irrespective of religious background. Aim: The aim of this study was to in a caring perspective illustrate patients’ spiritual and existential needs in palliative care. Method: The study is a literature review where 12 articles has been analyzed and summarized to give an overview of rescent research. The approach for the work of the analysis of the articles was qualitative content analysis. Results: The spiritual needs increase in palliative care. To handle the increased needs coping strategies are needed. Nursing staff, relatives and religion are considered by the patient to be important resourses in order to handle the situation. The spiritual needs are not always payed attention to because of lack of knowledge among health care personal. Discussion: The older generation are most likely more spiritual and religious convinced. The sum of this becomes that most of the palliative care patients have a religious belief, that might explain the meaning of spirituality in palliative care. Conclusion: The spiritual needs increase in palliative care and the most important as a nurse is to pay attention to and answer these needs. Through education and increased awareness of spiritual needs, the palliative care could improve considerably.