The client's ability to communicate is key to providing quality palliative end-of-life care. A speech-language pathologist (SLP) can facilitate the patient's ability to communicate concerns or preferences in order to (1) improve the health care team's ability to manage symptoms and engage in end-of-life discussions, and (2) support the patient and family's ability to maintain social connectivity. This article describes methods for implementing speech-language pathology communication consults in palliative or end-of life care. The information is illustrated with patient vignettes and supported by literature resources. Specific participation goals and outcomes illustrate the impact of the SLP treatment on the interprofessional team palliative care outcomes. Approaches to advocating for speech-language pathology communication consults in palliative end-of-life care are highlighted. Ongoing research and advocacy may result in valuable skilled speech-language pathology services for patients with communication barriers in palliative or end-of-life care.