The activities of daily living (ADL) of patients who have survived with long-term hemodialysis for over 30 years have not been studied well. We evaluated the ADL, patient history, and clinical data of 26 patients (18 male, 8 female) at our clinic who have undergone hemodialysis therapy for more than 30 years. These patients exhibited the following features: 1) Women had significantly higher ADL scores than men (p<0.001). 2) None of the patients were bedbound. 3) None of the patients had undergone coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty. 4) Underlying diseases included 1 case of systemic lupus erythematosus; the others suffered from chronic glomerulonephritis. None of the patients were diabetic. 5) The ADL status was not correlated with the age at hemodialysis initiation, dry weight, body mass index, history of parathyroidectomy, or surgery for carpal tunnel syndrome, or with levels of albumin, hematocrit, pre-dialysis blood urea nitrogen, and β₂ microglobulin. 6) The patients classified as “ambulatory” on the ADL scale had better kt/v values (p<0.05).