Objective: A rare and distressing emergency in palliative oncology, terminal haemorrhage presents a challenge throughout the course of management in at risk patients.Particularly in patients with advance cancer, with a preference for home death, where a do not attempt resuscitation (DNAR) order is in place and the patient is discharged home for end-of-life care at home.Following a limited literature review, we developed a guideline to support clinicians, health and allied health professionals in addressing this challenge.Method: A review and systematic search was undertaken of electronic database, grey literature, local guidelines from hospices and hospitals and online web portals.Following this, a management guideline algorithm for managing terminal haemorrhage in palliative care patients with advanced cancer discharged home at the end of their lives was developed.Results: With the limited evidence available presently in this field, we developed a practical userfriendly algorithm focused on the 3 major phases in this patient group: step 1 (preparing for the event)-optimise risks and factors predisposing to bleeding, step 2 (managing the event)-use ABC,and lastly step 3 (aftercare)-provide practical resources for clearing up at home immediately after the event, as well as psychological support to all those involved from family to health care professionals.The ABC mneumonic to be used during the event: A (assure and re-assure the patient),B (be there-above all stay with the patient), and C (comfort, calm and consider dark towels, and anxiolytics if at all possible).Conclusion: Our 3-step approach in managing this highly feared and potentially catastrophic emergency in palliative oncology aims to equip professionals with a logical framework for approaching patients with advanced cancer discharge home to die who are at risk of terminal haemorrhage.