In 1987 the UK became the first country in the world to make palliative medicine a subspecialty, to be followed by Australia, Hong Kong, New Zealand, Poland, Romania, Singapore, and Taiwan. Eighteen years later there are, in the UK, 310 consultant specialists, 161 SpRs, 6 professorial chairs, increasing research and palliative medicine is taught in all medical schools. This paper looks at the history of the subspecialty, the criteria that had to be met for specialist status, developments in palliative care provision in the UK and the challenges facing the young specialty, and those undergoing training.