BACKGROUND: Child neurologists require primary palliative care (PC) skills to care for patients with high symptom burdens and variable prognoses. The existing scope of PC education in child neurology training is unclear. We conducted a national survey-based needs assessment of pediatric PC education in child neurology residencies in the United States. METHODS: Resident and program surveys were developed and distributed via direct recruitment of program directors/coordinators and the Child Neurology Society Connect platform. Surveys were analyzed using descriptive statistics and exploratory posthoc comparisons in specific comparison groups. RESULTS: Seventy-nine residents and 18 programs completed the survey. Respondents represented all US census regions and neurology training years. Curricular and clinical exposure to six core pediatric PC topics varied: 17 (22%) residents participated in a PC rotation, three programs (17%) require a PC rotation, and 13 programs (72%) offer a PC elective. Increasing postgraduate year (PGY) level and PC elective experience were associated with increased confidence in elements of serious illness communication, and increasing PGY level was also associated with increased confidence in elements of neuroprognostication and palliative symptom management. Both residents and programs reported a desire and motivation for additional pediatric PC education. CONCLUSIONS: Current child neurology residents reported increased confidence over PGY level across three of six pediatric PC domains. Still, respondents reported desire and motivation for additional training. Our results highlight that although some primary PC skills are developed in child neurology residencies, there is a need for more formalized and enhanced pediatric PC education.