Approximately 1,500 people a day die of cancer. Most are cared for by an informal caregiver. The purpose of this study was to identify the unmet spiritual needs of informal caregivers and explore the relationships between the patient's symptom distress, caregivers' unmet needs, and caregivers' depressive symptomatology at the time of admission to hospice. The sample consisted of 110 caregivers of hospice home care patients with cancer. The Spiritual Needs Inventory and Center for Epidemiological Studies Depression Scale were administered to caregivers of newly admitted patients. The Memorial Symptom Assessment Scale was administered to patients. Regression analysis and correlations were calculated. An average score of 56.4 (possible range, 17-85) on the Spiritual Needs Inventory with a range of 0 to 13 unmet needs was reported by caregivers. Frequently cited as needed or unmet needs were those that related to outlook in life. Caregiver outlook, religious practices, and patient distress score predicted 17% of the variance in the unmet needs score. The unmet needs scores were significantly related (F [1,106] = 13.41) with the caregivers' Center for Epidemiological Studies Depression Scale scores. The study concluded that caregivers have specific spiritual needs that are not being met. Routine assessment of unmet spiritual needs facilitates caring for caregivers. To provide good end-of-life care, assessment of spiritual needs with a standardized instrument is recommended.