Although End Stage Renal Disease (ESRD) is a disease of increasing epidemiological relevance very little is known about the cost of providing the respective dialysis services in Tanzania. This study firstly analyses the existing literature and try to find out what we can learn from the state-of-the-art of the economics of dialysis on an international level. Afterwards, the study analyses the cost of outpatient dialysis at Muhimbili National Hospital (MNH) in Tanzania in the year 2014. Cost analyses were performed based on the provider's perspective including only direct costs of dialysis treatment. The results indicates an average unit cost per Haemodialysis is 175.91 US $. Consequently, on average patient requiring three dialyses per week (i.e 156 dialyses per year) will cause annual costs of US $ 27,441.95. The annual cost of dialysis is enormous for a least developed country like Tanzania where resources are rather limited. Therefore, from the economic point of view, It seems rational to allocate healthcare budgets towards diseases that are curable, have higher cost- effectiveness and cater for the majority of the population.