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There are several questions about hydration in terminal care: the discussion about whether or not, and if yes how much and by which route? Shows hydration any benefits regarding survival and symptom-control? Are there side-effects of hydration? The article tries to give an overview rather than a review over the literature of the last 10 years since there is no evidence about this topic. Three synergetic aspects will be recommended: 1. the knowledge about the medical argumentation in favor and against hydration and about techniques, 2. a communicative structure for decision making including health care providers, the patient and his family, and 3. the option of a time-limited therapeutic trial.