Paediatric palliative care (PPC) is gaining momentum in Bhutan, addressing the needs of children with terminal illnesses and their families. To support this, the first virtual workshop via ECHO platform on End-of-Life Care, Grief & Bereavement was conducted in collaboration with Two Worlds Cancer Collaboration, the International Children’s Palliative Care Network (ICPCN), and local partners. This three-hour workshop, as a part of the Children’s Palliative Care Leadership Programme, focused on equipping healthcare professionals with the skills and knowledge needed to provide holistic and compassionate care for children with terminal illnesses. The programme featured a diverse range of activities, including a case presentation by Dr. Narayan Rizal, a paediatric resident at Jigme Dorji Wangchuck National Referral Hospital in Bhutan. Dr. Rizal shared an insightful case, highlighting real-life challenges in caring for children at end of life. This was complemented by two didactic lectures: one delivered by Alex Daniels, Education Manager at ICPCN, and the other by Dr. Megan Doherty, Paediatric Palliative Director for South Asia at Two Worlds Cancer Collaboration, Canada. These sessions provided participants with evidence-based strategies and practical tools to address complex end-of-life care situations. The workshop brought together 24 participants, including paediatricians, nurses, allied health professionals, and nuns. These healthcare providers engaged in discussions on identifying children in need of palliative care and adopting the Paediatric Palliative Approach. The session’s content was tailored to Bhutan’s unique healthcare context, reflecting priorities identified by local professionals. A notable aspect of the programme was the potential involvement of Bhutanese nuns through the Bhutan Nuns Foundation. Recognizing the importance of spiritual care, the foundation is exploring ways to contribute to integrate and deliver spiritual care, which aligns with Bhutan’s cultural values, offering a holistic approach to supporting children and families. Dr. Tara Devi Laabar, PhD in Palliative Care and Lecturer at the Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, stated: “The ECHO PPC workshop on End-of-Life Care and Grief and Bereavement brought together doctors, nurses, and nuns from the Bhutan Nuns Foundation (BNF), led by Dr. Tashi Zangmo (PhD), the Executive Director of BNF. Discussions, included the role of CPR in advanced illness, the spiritual support nuns and monks provide in Bhutan’s palliative care. This session paved the way for a multidisciplinary care team, with plans to include more professionals in the future.” Dr. Tashi Zangmo (PhD), Executive Director of the Bhutan Nuns Foundation, also highlighted the impact of the workshop, stating, “In general in Buddhist tradition, there are unstructured method of end of life care. For example saying a prayer and asking the sick person to visualize in certain way etc. It does give the patients some comfort but it does not give actual proper focused care as such the Professional Palliative caregiver would give. The recent workshop give every one of us who participated a different idea and perspective care for the end of life and it was truly informative and one of the nuns say, “with the spiritual education we already have, now I feel that we have bit of delivery skills to help someone who is at end of life. But of course, one workshop is not enough, if we have to reach out to the people who are in need of such services, we need more workshops and relevant trainings”. This is what one of the nuns from the Eastern Bhutan who also received the basic care giver training in India before the recent Palliative care workshop online.” To highlight the importance of grief and bereavement services in Bhutan, Alex stated, “When we consider the unique needs of children before and during the time of death, there is much to reflect on.  If we want to establish an effective children’s palliative care service, high quality compassionate communication is crucial to create meaningful connections with families. Alex also emphasized the importance of self-care for caregivers, acknowledging the challenges of the role. Caring for yourself as a caregiver is important. We need to think about how we nurture ourselves and a daily personalized self-care programme is essential as well as integrating a structured programme to support the team through regular reflection, debriefing and supervision.” Dr. Megan Doherty congratulated the participants for actively engaging in the workshop. Reflecting on her experience, she shared, “I loved participating in the discussions and learning from all of you about how you think about the issues in Bhutan and how that will lead to change. You are the change makers.” The Royal College of Paediatrics and Child Health (RCPCH), UK, endorsed the Bhutan PPC ECHO programme, enhancing its international credibility and expanding its reach. The involvement of faculty from Bhutan, Canada, and South Africa underscored the global collaboration essential for advancing PPC as an emerging field. This workshop represents yet another significant milestone in developing paediatric palliative care in Bhutan. By empowering healthcare providers with practical knowledge and skills, it lays the foundation for a compassionate and sustainable care system. Initiatives like this not only enhance the quality of life for children with serious illnesses but also strengthen Bhutan’s healthcare infrastructure to address the challenges of palliative care with cultural sensitivity and global support.