What we know → Virtual reality (VR) shows growing promise as a supportive intervention in palliative care, with evidence suggesting benefit across multiple symptoms and few reported adverse effects. Advancing the field will require adequately powered trials that evaluate the clinical relevance of VR content. Current evidence suggests that head-mounted VR experiences are safe and effective in reducing symptom burden at the end of life. High-quality, personalized ‘bucket list’ experiences may further enhance impact. Notably, Huang et al. (2024) highlight the role of personalized VR content in alleviating both psychological and physical pain, with emerging data suggesting that patients with greater functional impairment may derive the greatest benefit.