Objectives: Even though previous systemic reviews have shown that peritoneal dialysis (PD) is associated with substantial improvements in patient survival and delayed graft function compared with hemodialysis (HD) treatment as a pretransplant modality, the association between pretransplant dialysis modalities and posttransplant outcomes remains controversial. Methods: We retrospectively collected records from 773 kidney transplant recipients between January 2008 and October 2021 in 2 transplant centers. We excluded recipients under the age of 18, 2nd or 3rd transplant recipients, and preemptive recipients. The final analysis included 561 kidney transplant recipients. We examined graft survival across pretransplant modality, HD and PD. Results: 561 kidney transplant recipients were 47.5±11.8 years old and included 42% females and 29% diabetes. 410 recipients underwent HD, and 151 recipients underwent PD before transplantation. The median follow-up duration was 5.7 years (IQR: 3.0, 9.3), 5.5 years (IQR: 2.9, 9.3), and 6.2 years (IQR: 3.5, 9.5) for overall, HD, and PD, respectively. The median dialysis vintage was 4.5 years (IQR: 1.5, 7.4), 4.5 years (IQR: 1.3, 7.6), and 4.4 years (IQR: 2.0, 6.8) for overall, HD, and PD, respectively. 35% of recipients who underwent pretransplant HD and 37% of recipients who underwent pretransplant PD were transplanted from living donors. The overall graft survival between pretransplant HD and PD showed no statistical difference (Log Rank P=0.188) (Figure). However, pretransplant HD seemed to be favorable for graft survival over a long-term follow-up period of over 10 years. Conclusions: Pretransplant modalities during the transition to a kidney transplant are not associated with graft survival. As follow-up duration increases, further studies on graft survival are warranted.