Hepatocellular carcinoma (HCC) is a disease associated with a heavy burden of symptoms, and a minority of patients are eligible for curative treatment. Many patients will need high-level palliative care. As most HCC patients are from LMICs, the need for palliative care is higher in these countries. Unfortunately, most of the LMICs do not have well-established palliative care programs. Pain control is one of the significant problems in these countries, with a lack of access to opioids. To improve that situation, there should be changes on different levels (governmental, political, educational, cultural, and social levels). Palliative care can be provided under different models, the choice of model based on each country’s situation and needs. Palliative care has multiple domains, and providers should know them all. Effective communication is crucial to conduct such care. Caring for the caregiver is an essential part of that care. Providers dealing with patients with serious illnesses should be familiar with hospice and end-of-life care, and efficient community-based teams should be developed.