Objective: This cross-sectional study included 148 dialysis patients at Soonchunhyang University Cheonan Hospital from August to September 2020. The patients responded to a questionnaire covering mental health status and COVID-19 related concerns. The symptoms of depression, anxiety, stress, and insomnia were measured using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) scale, the 22-item Impact of Event Scale-Revised (IES-R), and the 7-item Insomnia severity Index (ISI), respectively. We compared the outcomes between HD and PD patients by propensity score matching analysis Methods: Dialysis patients reported psychological distress including symptoms of depression, anxiety, stress, and insomnia. HD patients showed higher scores for depression (p = 0.018), anxiety (p = 0.005), stress (p < 0.001), and insomnia (p = 0.006) than the PD patients. After propensity score matching, HD was associated to the depression (p = 0.0131), anxiety (p = 0.0143), and stress (p = 0.000415). Results: Dialysis patients showed psychological distress during the COVID-19 pandemic period, and the HD patients had more severe symptoms than the PD patients. Conclusions: Objective: Previous studies have revealed that the COVID-19 pandemic has produced psychological distress such as depression and anxiety. Patients with chronic kidney disease (CKD) might be more vulnerable to psychological distress due to the COVID-19 pandemic and the impact could be different according to the dialysis modality. We aimed to investigate COVID-19-related psychological stress experienced by end-stage kidney disease (ESKD) patients, and the difference in concerns between hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: This cross-sectional study included 148 dialysis patients at Soonchunhyang University Cheonan Hospital from August to September 2020. The patients responded to a questionnaire covering mental health status and COVID-19 related concerns. The symptoms of depression, anxiety, stress, and insomnia were measured using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) scale, the 22-item Impact of Event Scale-Revised (IES-R), and the 7-item Insomnia severity Index (ISI), respectively. We compared the outcomes between HD and PD patients by propensity score matching analysis Results: Dialysis patients reported psychological distress including symptoms of depression, anxiety, stress, and insomnia. HD patients showed higher scores for depression (p = 0.018), anxiety (p = 0.005), stress (p < 0.001), and insomnia (p = 0.006) than the PD patients. After propensity score matching, HD was associated to the depression (p = 0.0131), anxiety (p = 0.0143), and stress (p = 0.000415). Conclusions: Dialysis patients showed psychological distress during the COVID-19 pandemic period, and the HD patients had more severe symptoms than the PD patients.