Moral distress in nursing is a prevalent theme in the literature. Although this issue has been investigated in other nursing disciplines, it has not been investigated by empirical research in the emotionally and ethically sensitive area of providing care to dying babies. Moral distress occurs when nurses are prevented from translating moral choices into moral action. The response to moral distress is anger, resentment, guilt, frustration, sorrow and powerlessness. If not addressed, self-worth may be jeopardised, affecting personal and professional relationships. A review of the literature was conducted to explore moral distress in neonatal nursing when providing care to dying babies. This literature review provides a basis for the direction of further research and hypothesis testing. Further focused research is necessary in this under-theorised area of nursing practice to clarify the significance of moral distress for neonatal nurses caring for dying babies.