Taiwanese indigenous spiritual care began in 1995 when the Hospice & Palliative Care Unit of National University Hospital was first established. The Unit received research grants to study the possibility of applying Buddha dharma in terminal care, then a training program for clinical Buddhist chaplains was launched in 2000. Taiwanese Association of Clinical Buddhist Studies was established in 2008 to provide the service network of clinical Buddhist chaplains. Taiwanese indigenous spirituality based on Buddhism is thus defined as: ”the ability to respond to, to realize and to understand the right dharma.” It is a life power, and it manifests the maturity of the mind. It emphasizes to regard patients as demonstrator, not only receiving care but also presenting how to face death.Qualified clinical Buddhist chaplains are required to successfully complete a rigorous training program consisting of classroom instructions as well as bedside practicum on applying Buddhist principles and practices to terminal care. According to the Four Noble Truths, clinical diagnosis and treatments can be stated as follows: (1) spiritual suffering is identified from the sickness categorized into physical, psychological, family, social and spiritual aspects according to the ”Five Skandhas”; (2) the Truth of the ”Origin” of Suffering is evaluated according to the ”Twelve Causes and Conditions”; (3) the goal of care (cessation of suffering) is planned according to ”Four Dwellings in Mindfulness”; (4) The effects of the practice of the Buddhist methods are carefully evaluated and recorded (the Truth of ”Path”).There are five stages in the framework of Taiwanese indigenous spiritual care, namely, truth telling, death preparation, spiritual responses, following and practicing Buddhist methods, and becoming a Buddha. In hospice and palliative care units, clinical Buddhist chaplains who have completed the proper training provide direct bedside care to terminal patients, resolve patients' spiritual sufferings, elevate their spiritual states and reduce their death fears. By following the Buddhist practices, patients transcend the worldly dharma, discover their internal power, improve their life quality and achieve good death. Buddhist chaplains also provide life and death education to family members, transform obstacles into assistance, reduce forthcoming grief, and elevate the morality of the hospice and palliative care team. To sum up, the application of Buddha Dharma in hospice and palliative care is truly a unique feature of Taiwanese indigenous spiritual care system.