The prevalence and incidence of end-stage renal disease (ESRD) are increasing in developed and developing countries, and this will place an enormous financial burden for health-care systems. The exact reasons of the rising prevalence of ESRD patients are unknown, but it can be attributed to an increase in the prevalence of diabetes mellitus and hypertension as the most common causes of ESRD. However, in contrast to the developed countries, the etiology of ESRD in the significant percent of patients with ESRD in Iran is unknown. In our country, the patients with chronic kidney diseases present themselves to the hospital only when they have severe symptoms of uremia, and, at this time, determining the primary cause of ESRD is often not possible. In addition, although the prevalence and incidence of ESRD are also significantly increasing in Iran in recent years, they are still lower compared with developed countries, which may also be due to poor referral resulting in the under diagnosis of ESRD. The aim of this review is to evaluate the epidemiologic aspects of ESRD in Iran, including demographic data, cause of ESRD, kind of renal replacement therapies implemented and their survival.