Palliative care is an actively developing area. A separate area of palliative care is palliative care for children and their families, that is, support for children and adolescents and incurable, progressive diseases up to the age of 18. The relevance and demand for palliative and hospice care is confirmed by the growing number of patients in the North-Western Federal District who need them. In 2018, the Leningrad Region opened the State Autonomous Health Institution of the Leningrad Region Childrens Hospice (hereinafter the Childrens Hospice). The mission of the Childrens Hospice is to provide assistance where recovery is impossible, which is realized in an individual approach to each patient, taking into account his resources and environment, and not a diagnosis. The main goal is to improve the quality of life of children with incurable diseases and their families through providing them with multidisciplinary assistance. Childrens Hospice implements unique support programs for children with life-threatening or life-limiting diseases. The directions of development of the Childrens Hospice are outlined, related to the presence of myths and stereotypes in society, the remoteness of the districts of the Leningrad Region, the difficulties of interdepartmental interaction with regional healthcare institutions, the peculiarities of interaction of patients with specialists of various healthcare institutions and the occurrence of iatrogenic injuries, issues related to the anesthesia of patients. Promising growth points have been outlined that will optimize palliative care for children. In particular, conducting educational work, opening outpatient branches in certain districts of the Leningrad Region which will allow observing the time interval of the assistance provided.