Background <p>Pediatric palliative care aims to improve the quality of life for children with life-threatening diseases. The requirements and approach to pediatric palliative care differ greatly from adult palliative care. Palliative care has been introduced and grown in India; nonetheless, there is an urgent need for pediatric palliative care services, as this speciality is still in its nascent stages. This systematic review was undertaken to understand the perceived challenges of pediatric palliative care in India. </p> Method <p>The articles were chosen based on different search terms and criteria. A total of 482 items has been identified from three separate databases. 55 articles were selected for full-text analysis, and 10 of them were chosen for review. PRISMA guidelines were used in the article selection process.</p> Results <p>The current evidence reveals the need for pediatric palliative care all over the country, and Lack of training, knowledge, NGOs providing palliative care, especially for children, the stigma associated with the field, the lack of resources, and the absence of appropriate policies specifically for child palliative care are the challenges that have been identified.</p> Conclusion <p>Multiple challenges in pediatric palliative care indicate the effective implementation of it in the health care system. Proficient control of these challenges can drive the advancement of pediatric palliative care for children and their families.</p>