The environmental crisis is producing an increasing number of both physical and psychological impacts. This article studies the challenge of eco-anxiety for pastoral care, drawing from both interdisciplinary research and ecological theology. The aim is to help both practitioners and researchers to encounter eco-anxiety more constructively. The rapidly growing research about eco-anxiety and therapy is discussed in relation to pastoral care. The various forms of eco-anxiety are briefly analyzed. The role of the caregivers is discussed by using sources that study the challenges of therapists in relation to eco-anxiety. The existential depths of eco-anxiety are probed in the light of recent research and older existentialist theory. It is pointed out that the political character of ecological issues, especially climate change issues, causes many kinds of challenges for pastoral care. As the constructive conclusion of the article, various possibilities and resources for encountering eco-anxiety in pastoral care are discussed, along with the connections with wider pastoral theology. It is argued that pastoral care providers should engage in self-reflection about their own attitudes and emotions related to ecological issues, preferably with the support of trusted peers or mentors. Various organizational developments are also needed to support caregivers. Dialectical thinking is one tool that can help to navigate the complex dynamics related to environmental responsibility, eco-emotions, and questions of hope or hopelessness.