Patients with cancer and their care givers frequently wish to know how long they expect to live. Improved prognostication would enable the patients and their carers to be better prepared for their impending death and allow clinicians to make better informed decisions about place of care.The aim of this prospective observational cohort study is to validate the Palliative Prognostic Index (PPI) in a population of terminally ill cancer patients referred to the palliative care unit of Kasr Al-Aini Center of Clinical Oncology and Nuclear Medicine over three months period, in order to determine its applicability in a different setting to that in which it was originally developed.The PPI is based on the following variables: Palliative Performance Status, oral intake, oedema, dyspnea at rest and delirium. A numerical score was given to each variable, based on the original value of the PPI score. The individual PPI scores are calculated for 100 incurable cancer patients; the sum of the single scores gives the overall PPI score for each patient and is used to subdivide the study population into three groups: Group 1 corresponded to patients of low PPI ≤ 4 with median survival of 107 days, Group 2 of intermediate PPI > 4 and ≤ 6 with median survival of 103.5 days, and Group 3 of high PPI > 6 with median survival of 77 days, compared to 68, 21 and 5 days of corresponding groups respectively as reported by Stone et al. Current study showed that the median survival according to PPI was higher than other studies which could be attributed to relatively earlier referral of Egyptian advanced cancer patients to palliative care without exhausting patients with several lines of palliative chemotherapy.With this earlier referral the PPI may not be the best prognostic scoring system for palliative care Egyptian advanced cancer patients, so that further studies to evaluate other systems and to develop a suitable model is needed.