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Studies of patients who are terminally ill consistently identify strong associations between ‘‘sense of burden to others’ ’ and marked end-of-life distress. However, little research has addressed the issue of burden to others among patients nearing death. The aim of this study was to carefully examine ‘‘burden to others’ ’ and clarify its relationship with various psychosocial, physical, and existential issues arising in patients who are terminally ill. A cohort of 211 patients with end-stage cancer was assessed, using an assortment of validated psychometrics to document psychosocial, physical, and existential aspects of their end-of-life experience. This included an assessment of their sense of ‘‘burden to others.’ ’ Forty percent of participants indicated a negligible sense of burden to others, scoring within the lowest quarter on an ordinal measure of ‘‘burden to others;’ ’ 25 % scored within the second lowest quarter; 12 % within the third quarter; and 23 % within the highest or most severe range. The most highly correlated variables with ‘‘sense of burden to others’ ’ included depression (r 0.460; df 201, P< 0.0001), hopelessness (r 0.420; df 199, P< 0.0001), and outlook (r 0.362; df 200, P< 0.0001). Four variables emerged in a multiple regression analysis predicting burden to others, including hopelessness, current quality of life, depression, and level of fatigue [R2 adj 0.32, F(6,174) 13.76, P< 0.0001]. There was no association between sense of burden to others and actual degree of physical dependency. Feeling a sense of burden to others is common among dying patients. Although 40 % of the sample reported little in the way of sense of burden to others, the remainder endorsed higher degrees of burden-related distress, with 23 % scoring within the most severe range. The lack of association between ‘‘sense of burden to others’ ’ and the degree of physical dependency suggests this perception is largely mediated through psychological and existentia