Central venous catheters have emerged as a valuable alternative for permanent access in hemodialysis. Thanks to steady improvements of materials and design they have been successfully used as bridging solution until another vascular access became available or even long term solution for patients with limited or insuffisant vascular resources. Since the use of central venous catheters is affiliated with a higher dysfunction rate and morbidity, special attention is indicated. This should include regular surveillance, clinical examination and intervention using specific methods, bacteriological exams and regular dialysis quantification. Such a constant quality control followed by strict and adapted rules for catheter handling are essential necessities to reduce catheter-related complications and assure an adequate dialysis.