Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced life-limiting diseases. In cancer patients, it is defined as ‘distressing persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning’. In the majority of patients receiving palliative care, the aetiology of fatigue is multifactorial. The most common factors associated with fatigue include anorexia/cachexia, pain, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue. Initial management should aim towards identification and treatment of the reversible/underlying causes However, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered.