This study investigated spirituality and the spiritual changes people living with dying may experience. The study was based on a phenomenological perspective where the centrality of the participant’s personal worldview and experiences was highlighted. Data was gathered through open and semi-structured interviews with three participant groups: health care professionals working in palliative care and hospices, people who had experienced a serious or life-limiting health condition, and the caregivers of terminally ill patients. Interviews were recorded and transcribed verbatim. A thematic analysis approach was used to analyse the data. The findings showed a diversity of spiritual understandings and suggested that participants understood neither religion nor spirituality in exactly the same manner. The analysis revealed that some participants used religion to describe their understandings of spirituality. Some participants regarded the terms ‘spiritual’ and ‘religious’ as synonymous while for others the terms were conceptually independent. Participants used a variety of definitions to describe spirituality. These primarily involved regarding spirituality as a belief in a God or a higher being, or as a relationship with or connection to a God or higher being. Participants also viewed spirituality either in terms of the human spirit or soul and its continued existence into an afterlife, or in terms of mysterious events and the paranormal. Findings further revealed that many people living with dying described periods of gradual spiritual growth, or sudden and unexpected spiritual transformation: however, not all people reported spiritual changes. These findings imply that people may have a dominant spiritual perspective through which they understand experiences. Identification of these perspectives in clinical settings may make it possible to tailor spiritual support resources according to individual spiritual perspectives. However, further exploration of the different spiritual perspectives is suggested as different groups may have different spiritual needs.