Long‐term central venous catheterization has been used as the sole method of vascular access in nine chronic dialysis patients with severe access difficulties. The catheters were inserted into the right atrium via external or internal jugular veins by a simple operative technique and have remainedin situfor 1–33 months. Although three catheters required replacement for incorrect positioning (two patients) and catheter‐associated thrombosis (one patient) no patient failed with the technique. Catheter‐related complications were infrequent. The study demonstrates that it is possible to undertake adequate and safe haemodialysis through a permanently indwelling central venous catheter in patients in whom conventional methods of vascular access, and other modes of renal replacement therapy, have failed rep