Palliative sedation is the skilled use of medications to lower a patient’s awareness to manage severe and refractory symptoms such as pain and/or terminal restlessness in the last days of life.Propofol is an ultra-fast acting anaesthetic commonly administered in high dependency units with continuous montiroing. We described a young woman managed in an acute hospice setting with metastatic breast cancer who had developed severe delirium on the background of intractable pain from extensive fungating cuteaneous wounds. Despite the use of large doses of varying antipsychotic, benzodiazepine and barbiturate, she remained agitated, in pain and at risk of falls or self harm. The use of propofol intravenously was successful in achieving sedation and peace in her last three days of life.