Multiple System Atrophy and Progressive Supranuclear Palsy have profound symptom burdens. Palliative care is emerging as an adjunct to neurological input in neurodegenerative disorders. Basic palliative care can be provided by all clinicians with referral to specialist teams if needed. Palliative care need in MSA and PSP exists at a level equivalent to advanced cancer. Palliative care input has been found to improve quality of life in patients with MSA and PSP.