Objective: To determine whether hospice enrollment at the time of a terminal admission alters the length of stay (LOS) or costs compared with patients not enrolled in hospice. Methods: Retrospective chart review of all nontraumatic inpatient deaths of patients with a previous admission in the preceding 12 months at an academic hospital. Results: 209 patients had a nontraumatic death and an admission in the year prior to the terminal admission. Patients enrolled in hospice had a shorter LOS (P = .02) and lower cost (P < .0001) than patients not enrolled at the time of their terminal admission. Conclusions: Enrollment in hospice during a terminal admission decreased cost and LOS. Hospice may be a way to provide more cost-effective, appropriate care to dying patients.