Experience alone is not enough to ensure optimal doctor-patient communication at the end of life — formal communication skills training (CST) is necessary to produce improved outcomes. This chapter outlines the goals and strategies for end-of-life CST, emphasising common decision-making dilemmas, such as withdrawal of life-extending treatment and do-not-resuscitate directives. Common pitfalls seen in training are identified. The goal of end-of-life communication training is discussed, along with smoother implementation of palliative care, patient-centred communication in cancer care, and specific strategies for end-of-life communication such as gathering specific information about wishes and thoughts regarding death and dying.