Cancer is a chronic disease with associated physical, emotional, social, financial and spiritual problems. The primary caregiver takes care of all these cancer-related issues for the patient. In India, usually a family member or loved one is the caregiver of the patient. The caregivers themselves feel distress and many factors may be associated with their psychological well-being. Pattern of distress may vary according to phases of the disease like at diagnosis, during ongoing oncological treatment, recovery period, remission period, recurrence of cancer, during end of life care and bereavement. Identifying and understanding caregiver distress is the first step. Active listening and good communication is important to unearth the real concerns and fears in order to relieve the distress. This chapter covers components of caregiver distress, assessment, physical, psychosocial and spiritual factors associated with distress and its management. Lastly, some recent literature related to prevalence and factors associated with caregiver distress.