The last decades brought huge advances in medical technology and pharmacology. One area that reflects this progress has been the administration of nutrition and hydration. These are controversial therapies at the end of life, especially when administered by artificial means. The objective of this review was to discuss and comprehend the current and global knowledge about ethical issues related to food, nutrition and hydration in the end-of-life care. The problematic situations analyzed include: advanced directives, the concept of basic human care or treatment, the meaning of food and fluids, the withholding and withdrawing of nutrition and hydration, risks and benefits of nutritional support and the concept of voluntary stopping eating and drinking.