Nineteen patients believed to be in the terminal stages of cancer were evaluated for signs of delirium. Six patients improved; 13 who died during hospitalization were studied until their death. Patients were interviewed three times a week using a delirium scale; medical records also were used to gather data. Eleven (85%) of the 13 patients developed delirium. In most patients, delirium was caused by multiple factors. The authors outline strategies for management of terminal cancer patients with delirium.