Introduction: Radiotherapy is an underutilized resource in pediatric palliative care; however, it is useful in relieving various symptoms at the end of life. Patients and methods: A retrospective study of 30 pediatric patients who received radiotherapy for palliative reasons is shown. The objective was to review whether radiotherapy was beneficial. Results: Radiotherapy was useful in relieving symptoms, showing an overall response in 87% of cases and with mild toxicities. The poorest responses were in gliomas with relief in 56% of cases showing toxicity in 89%. The need for anesthesia and irradiation at early ages were predisposing factors for the development of toxicities. Conclusions: The use of palliative radiotherapy is beneficial and should be included in the multidisciplinary management of the child in palliative care.