Background: Telephone consultation for patients and their relatives is a new aspect in the area of palliative care (PC). The centre for palliative care (CPC) in Dhaka, Bangladesh has been delivering a 24/7 telephone service since 2009. Aim: The aim of the study is to describe this 24/7 PC telephone consultation service (TCS); the development and the use of the service and the challenges experienced by the physicians delivering the consultations. Methods: A descriptive mixed method study. Data on telephone consultations were collected from (CPC) from 2009 to 2016. Descriptive statistics were used to identify characteristics of patients, callers’ relationship to patients, reasons for calling, and suggestions/advice provided. A group interview with the consulting physicians was conducted and analysed to describe the development of the service and the challenges experienced. Results: From December 2009 until August 2016, a total of 4195 calls were registered from palliative patients and their carers. The service was utilized most frequently by informal caregivers of patients (80%), pain was the most commonly recorded symptom (24%), and suggestions were mainly provided about general medicine (31%). The service providers are facing many challenges but they are motivated by the positive feedback from patients and carers and by the ability to at least do something. Conclusion: The TCS developed at CPC is a convenient way of delivering advice to palliative patients and their families in rural areas of Bangladesh, where the PC service is not available.