Kidney transplantation (KT) is the most successful treatment for end-stage renal disease patients. But objective data about patients' willingness to undergo kidney transplant is still lacking in Pakistan. Objective: To assess barriers to KT and identify factors which could influence the willingness regarding KT among hemodialysis dependent patients.  Methods: This cross-sectional study carried out at Dialysis Unit, Dept. of Urology and Kidney transplantation Lahore General Hospital, Lahore on 100 hemodialysis dependent patients by completion of structured questionnaire about their knowledge and attitudes toward KT and how satisfied they were with dialysis. Results: The mean age of the patients was 42.8 ± 10.6 years with 55% male and 45% female patients. The percentage of patients who were willing to get a kidney transplant was 60%. The main reason of unwillingness to undergo KT was lack of donor (83.3%). Motivating factors in patients to choose KT were vascular access constraints 75%, studies or work difficulties 70%, fluid and dietary restrictions account for 63.3%. The percentage of patients who wanted a deceased kidney for transplant was 50%, whereas the percentage of patients who preferred a living kidney for transplant was 25% (17 % relatives and 8% non-relatives) and 25% of patients had no preference. Conclusion: Willingness to get kidney transplant is relatively low in Pakistan. Lack of donor, fear of surgery and financial problems are the main barriers for KT in ESRD patient

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