The pros and cons of subclavian vein hemodialysis catheters are reviewed. The subclavian vein catheter offers rapid and adequate vascular access. Other advantages are preservation of patient mobility and the ease with which the dressing can be secured. In contrast, subclavian vein stenosis has recently been identified as an important long-term complication of subclavian vein catheters that seriously compromises the creation and long-term viability of later ipsilateral arteriovenous fistulas. For this reason, we recommend restricting use of the subclavian hemodialysis catheter for acute situations and preferential use of internal jugular catheters for more chronic approaches because they better preserve venous integrity.