Purpose of ReviewIn this article we will examine the basis for using chronic high dose parenteral iron therapy in dialysis patients.Recent findingsThere are increasing data that dialysis patients fare better in many respects if they have higher hematocrit values although the real optimal hematocrit has not been defined. There is an increasing tendency to use parenteral iron to achieve this goal.SummaryAlthough parenteral iron achieves seemingly favourable short results, there are no data for its safety in the long term. On the contrary, there are reasons to suggest possible iron overload with chronic use.