Although pediatric palliative care has become more accessible over the past decade, little research has been performed that focuses on the financial impact of providing palliative care in an inpatient hospital setting. Using a case-controlled methodology, health care costs and the distribution of these costs were compared between children who received palliative care to those who did not. In comparing children who received palliative services to case controls, the similarities are striking, and the differences may have clinical significance. Children receiving care coordinated by the palliative care program underwent fewer radiology procedures and received greater assistance from pharmacologic services. This reflects greater attention and interventions provided to treat pain and provide comfort.