Although there are many differences regarding what palliative care is and to whom it should be delivered, its delivery and integration earlier in the disease trajectory have been advocated since 1990. More recently, there has been a heightened interest in early access to specialist palliative care through its provision earlier in the disease trajectory to improve patient and caregiver outcomes. This article explores the challenges in understanding and defining ‘early’ specialist palliative care. It also examines the available evidence on early specialist palliative care interventions and their association with patient and caregiver outcomes. Finally, recommendations for future direction of research and practice are discussed.