Objectives: To report on 2 cases of metastatic renal cell cancer treated with sunitinib during chronic hemodialysis. Methods: Two patients who were receiving chronic hemodialysis were treated with escalating doses of sunitinib with close clinical and laboratory surveillance. Results: The treatment toxicities were tolerable even after dose escalation. The first patient had a complete response after 5 treatment cycles and the second patient had stable disease after 13 treatment cycles. Conclusions: Sunitinib treatment is feasible and effective against metastatic renal cell cancer with the patient receiving chronic hemodialysis. Patients with terminal renal failure can be offered sunitinib treatment with close clinical and laboratory monitoring.