The implementation of shared decision-making in pediatric palliative care can reduces decision conflict and decision regret, and increases participation in decision-making and satisfaction with care. This paper reviews the approaches and steps of implementing decision-making in pediatric palliative care, analyzes the barriers to the implementation of shared decision-making in pediatric palliative care, and proposes strategies to promote the implementation of shared decision-making in pediatric palliative care, aiming to provide scientific basis for the implementation of shared decision-making in pediatric palliative care in China.