Gratitude is a natural part of life, especially when appreciating what another has done. We have all felt and perceived gratitude at times, even in situations of serious and advanced illness. Surprisingly, gratitude for life persist at the end of life. This book focuses on profound gratitude in palliative care. It explores what gratitude is in this context, who expresses it, how it happens, its impact, and the influence of culture. The book emerges from a collaboration between clinicians and philosophers, blending clinical experiences and reflections to reveal gratitude in relationships between seriously ill patients and health professionals. It examines key aspects such as the concept and reason for gratitude, and its transformative power for patients, families, and professionals amidst vulnerability due to serious illness.