There is mounting evidence of the physical therapist’s role in hospice and palliative care (HPC) for optimizing quality of life and engagement in remaining life activities. The purpose of this clinical summary is to describe the variety of roles and clinical approaches that physical therapists are able to contribute to the care of patients with a life-threatening or terminal illness. In addition, culture, religion, and individual patient/family preferences tend to be contributing factors as they relate to physical therapy (PT) in HPC. Physical therapists have multiple practice patterns that they can use in HPC for a variety of clinical signs and symptoms, patient situations, and disease trajectories. Access to PT services is inconsistent and often depends on the understanding of the role of PT within HPC. In addition, providers must acknowledge varying levels of acceptance and integration of PT and HPC based on individual and contextual factors. In order to optimize remaining quality of life and optimize care and safety, PT and HPC should be integrated in a collaborative, prospective manner, and PT should be closely integrated with the entire interdisciplinary HPC care team.