The number of patients affected by cancer on maintenance hemodialysis has been increasing. Only few data on the cytotoxic drugs management are reported in the literature. Chemotherapy schedules commonly used in colorectal cancer necessitate dose adjustment and appropriate timing relative to the hemodialysis session. Here, we report a case of a 66-year-old male patient under hemodialysis and affected by metastatic colorectal cancer, unsuitable for standard chemotherapy. He received cetuximab monotherapy at a dose of 400 mg/m for the first dose, and then 250 mg/m weekly after hemodialysis and 3 days before his next run of dialysis. After 3 months of treatment, computed tomography scan showed a partial response of disease and the patient experienced a clinical benefit, without significant toxicities. We confirmed the feasibility and efficacy, with acceptable toxicity, of a standard schedule of cetuximab in patients under hemodialysis.