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Palliative cancer rehabilitation plays a critical role in optimizing function, alleviating symptom burden, and enhancing quality of life for individuals with serious or terminal illness. Despite its benefits, rehabilitation and other supportive care services remain underutilized, often due to the lack of ongoing need assessments throughout the survivorship continuum. Physiatrists are uniquely positioned to lead palliative rehabilitation across diverse care settings, using a multidisciplinary approach to address physical decline, psychosocial distress, and caregiver burden. These interventions can improve the quality of survival, support goal-concordant care, and bridge gaps in end-of-life care by aligning functional needs with comfort-focused goals.