Introduction: Treatment limitations ensure patients do not receive care that is futile or against their wishes. Documentation of treatment limitations can improve end-of-life care by preserving quality of life and limiting treatment escalation. Objective: To explore treatment limitation documentation and practices in patients who died during 2018 in four Victorian adult intensive care units. Methods: A retrospective medical record audit was conducted for 430 deceased patients. Qualitative and quantitative data were collected to describe documentation of treatment limitation practices, including the rationale for the practices and who was involved in decision making. Results: In all, 77% (n=332) of deceased patients had a completed treatment limitation form. Of those, 62% (n=207) were for curative or restorative limitations, with 30% (n=99) for palliative or terminal care. In 35% (n=117) of deceased patients, there was evidence of multiple changes to the treatment limitation, but with little evidence or explanation as to why. Changes were most common for patients starting with no limitations through to terminal care; however, changes were also documented with patients having curative or restorative limitations reverting to no limitations. Some patients had partial limitations such as to allow for defibrillation, but not cardiopulmonary resuscitation. Despite medical record provision for doctors to date the treatment limitation form and to record whether next-of-kin were consulted, such evidence was rarely recorded. Conclusions: Accurate documentation of treatment limitations is essential to delivering high quality, end-of-life care. In many patient cases, documentation of treatment limitations was incomplete. These findings suggest that a more coordinated and collaborative approach among clinicians, and between clinicians and next-of-kin is required to reduce confusion for clinicians and minimise unwanted and burdensome treatment.