Clinical ethics consultation (CEC) in Europe originated with a certain delay compared to North America, but its historical development led to a rich array of diverse approaches, concepts and practices. While retracing its history, the authors highlight some of the important pioneers that paved the way of CEC in Europe. Today, European CEC faces significant challenges in establishing the practice especially in the Eastern and Southern regions of the continent, integrating the diverse philosophical traditions into CEC and assuring comparable quality of CEC, based on a close collaboration with CEC elsewhere in the world.