Since 1988 a palliative care programme has been in development in Palermo, a large town in Southern Italy. The main objective is to provide home palliative care in conditions in which no other facility exists to meet the needs and reduce the distress of terminal cancer patients. This programme has been implemented and extended to other cities and villages in Sicily. A team composed of physicians, nurses, social workers and volunteers looks after patients at home. This model has been recognized as highly effective. The activities, the problems related to the development of such programme, including those concerned with the sociocultural environment and the family doctor, the needs of specific hospital departments, and the scientific and educational activities, are pointed out.