OBJECTIVES To provide a general overview of tumor lysis syndrome (TLS) focusing on the incidence, epidemiology, and patient outcomes associated with the syndrome; review the role of the oncology nurse in impacting patient outcomes and identify evolving issues relating to TLS. DATA SOURCES Primary and tertiary literature related to TLS and clinical practice experience. CONCLUSIONS Issues related to TLS continue to evolve and the oncology nurse plays a key role in patient management. As with other neoplastic disease-related complications (e.g., pain, nausea/vomiting), knowledge of TLS and attention and intervention, where appropriate, can positively impact patient outcome. IMPLICATIONS FOR NURSING PRACTICE The oncology nurse plays a critical role in impacting patient outcomes with respect to TLS ranging from collaboration with other disciplines to identifying patients at risk, through assessments, vigilant monitoring, and implementing optimal treatment regimens.