Paramedics play an integral part in community end-of-life care (EoLC) in the UK, especially given the lack of out-of-hours cover by palliative care specialists. Despite this, there remain multiple barriers to their fully effective provision of such care. This article provides a brief historical overview of paramedic practice, before highlighting some of the barriers to effective paramedic EoLC provision and introducing examples of collaborative work in the UK that aim to overcome these. The author hopes this will support improvements in paramedic-led EoLC. Given the similarities in the international evolution of paramedic education, readers from other countries will be able to relate to these findings.