Objective To determine that powerful counseling can lead to correct choice of dialysis modality in end-stage renal disease (ESRD) patients. Methods One hundred and four ESRD patients in our hospital during 2003 to 2004 have been enrolled in this study. They have received a new concept pre-dialysis counseling respectively, and their choice of dialysis modality has been analyzed. Results In this group of patients, hemodialysis and peritoneal dialysis have been chosen almost equally, and this result had much more difference with popular high proportion of hemodialysis in China. Conclusion A powerful counseling can impel the ESRD patients to make a rational choice of dialysis modality, and help to ensuring a good cost-benefit ratio in dialysis therapy.