Aims: The incidence of chronic End-Stage Renal Disease (ESRD) is rapidly increasing among the Palestinian population in the last few years. Therefore, it is important to study the factors that influence this increase. This study is aimed to investigate the major risk factors that led to increased ESRD that requires hemodialysis in Northern West Bank. Methods: A literature review was conducted to determine the causes of ESRD, treatment, complications, incidence and preva-lence in developing and developed countries. Results: The major risk factors that are significantly associated with the onset of ESRD include diabetes mellitus, hypertension, cardiovascular disease, recurrent taken analgesic drugs and infection of the urinary tract. Conclusion: Identifying major risk factors affecting ESRD is an important topic. There should be more attention to improve the quality of renal replacement therapy and facilities. This could be achieved through increasing the number of qualified staff and the dialysis machines. Furthermore, knowing the causes will help to focus on prevention and early treatment. This will reduce health system costs associated with ESRD.