An increasing number of patients with end-stage kidney disease (ESKD) are being initiated on long-term dialysis every year in Canada. Hemodialysis (HD) and peritoneal dialysis (PD) are the two main types of dialysis provided under Canadian renal care programs. In HD, the patient’s blood is circulated to an external dialysis machine, which filters wastes and extra water from the blood before returning it to the body. In PD, a permanent catheter affixed to the abdomen is used to fill the peritoneal cavity with a dialysis solution. The peritoneal membrane functions as a filter for wastes and extra water, and the dialysis solution is exchanged, either intermittently or continuously. In all provinces, HD remains the modality most frequently used for new patients who require dialysis. In 2013, the rate of ESKD patients initiated on HD varied from 91% in Newfoundland and Labrador to 71% in Manitoba. Moreover, for the same year, most Canadian dialysis patients (76%) received in-centre HD — HD performed in an institution such as a hospital, satellite unit, or a dialysis facility, with the assistance of a health care professional. In contrast, home-based therapies such as PD and home HD show low rates of usage according to the latest available data. In 2013, about 19% of new ESKD patients in Canada were initiated on PD, while this rate was 0.6% for home HD. For the same year, the prevalence for patients being treated by home dialysis across the country was about 17% for PD and 2.5% for home HD. Available evidence suggests that PD and home HD may achieve similar clinical outcomes for some patients compared with in-centre HD. Studies also indicate that PD and home HD are potentially more cost-effective relative to in-centre HD. Based on the potential comparable clinical effectiveness and potential cost savings that they may yield, it is often argued that home dialysis therapies, particularly PD, may be underutilized in eligible patients in Canada and other developed countries. Similarly, the literature and jurisdictional input suggest growing interest in other dialysis delivery models, namely, “self-care” in-centre HD, “assisted” PD, and home HD. These options may allow for effective clinical results while being potentially less costly than standard in-centre HD and may also be more desirable from a patient and caregiver perspective.