proper management of symptoms allows terminal patients and their loved onesfamily the time to resolve emotional, psychological and spiritual issues. dyspnea is a common problem for patients with terminal conditions and effective clinical strategies can relieve symptoms in most cases. symptomatic management can be carried out concomitantly with the correction of the underlying cause when justified, although opioids are the first line of drug therapy, supplemental oxygen and benzodiazepines may help when they are indicated. in cases which are refractory to treatment sedation may be appropriate. we review in this paper the optimal management of dyspnea in patients with terminal conditions based on the most relevant recent evidence.