Background: There are no studies comparing the outcomes of embedded consults (EPC) as compared to independent outpatient palliative care consults (PC).Our aim was to determine the timing of palliative care access, symptoms and EOL outcomes of advanced non-small cell lung cancer patients referred to EPC as compared to those referred to PC. Methods: We retrospectively reviewed a random sample of EPC (Aug, 2012 - Jun, 2013) and PC consults (Jan, 2009 –Jul, 2012) at MD Anderson Cancer Center. Baseline features, symptoms (ESAS), EOL quality outcomes (intensive care unit deaths, admissions, emergency center visits , and hospitalizations and length of stay in the last 30 days before death; cancer treatments 14 days before death; hospice discussions and referrals; do not resuscitate order at first follow-up; advanced care planning (ACP) discussions, and completion of advanced directives), time from referral to first consult, ACP date to death, and overall survival from consult to death were retrieved. Results: 340 were evaluable (EPC = 147). At baseline, mean ECOG (2.2 vs 1.9, p < .001), and median pain (6 vs 5, p = .038) were higher in EPC. Time from referral to first consult was shorter (median 0 vs 7 days, p < .001) and dyspnea was better in EPC at follow-up (-1 vs 0, p = .039). A higher proportion in EPC (77% vs 58%, p < .001) had ACP discussions and these occurred earlier (median 4 vs 1 month before death, p < .001). No other significant differences in symptoms or EOL outcomes were found. Conclusions: EPC consults at referral had earlier access and worse pain and performance status. EPC was not associated with significant improvement in symptoms or EOL outcomes except for better dyspnea control, and more frequent as well as earlier ACP discussions. Further research is needed.