Background: Suffering of patients in end-of-life care is an extensive part of the work for nurses and the goal of palliative care is the greatest possible well-being, symptom relief and alleviation of suffering. Experiences of patients highlight difficulties in alleviating suffering in end-of-life care, which includes both physical and existential suffering. Aim: To describe nurses' experiences of patients suffering at the end of life. Method: A general literature review was conducted. Twelve qualitative articles and one article using a mixed method were included and analyzed. Results: Five themes were identified that highlighted the experiences of suffering in patients at the end of life: pain relief, relatives' participation, conversation, the importance of presence and need for knowledge. Nurses experienced patients suffering to more than physical pain and alleviation of suffering required a holistic view of patients. The relationship between nurses' and patients was considered to be the basis of palliative care and a fundamental part of improving the quality of life for palliative patients. Conclusion: Nurses' experienced challenges in faceing physical, mental, social and existential suffering as well as patients pain. Nurses experienced relatives as a resource for patients at the end of life both in pain relief and pain management. Nurses experienced presence and reception as important in difficult conversations.