Dyspnoea is a common, distressing symptom and difficult to control with medical treatment. The role of oxygen in reducing the severity of the symptoms and improving quality of life is still unclear. A working party of the Association of Palliative Medicine Science Committee set out to examine the evidence concerning the use of oxygen for the palliation of breathlessness in COPD, advanced cancer and chronic heart failure and to make recommendations for clinicians working in palliative care. There were very few randomised controlled trials available for any of these conditions. There was no evidence available for heart failure, very little for advanced cancer and although there were a number of trials on the use of oxygen in COPD very few, until recently, used reduction of breathlessness as an outcome measure. Recommendations are made on the basis of the evidence available and expert opinion such as the Royal College of Physicians report on the use of domiciliary oxygen. Oxygen use has to be tailored to the individual and a formal assessment made of its efficacy for reducing breathlessness and improving quality of life for that person [corrected].