Home hemodialysis (HHD) as a modality continues to remain an enigma and also largely underutilised. This study, a first of its kind, is a survey on the views of both nephrologists and patients to better understand the issues and offer solutions Methods 184 nephrologists from across India and 54 patients currently undergoing HHD were surveyed on a standard questionnaire. Also, survival data of all the HHD patients from 2012-2023 (n=560) were analysed. Results 33% Nephrologists believed that HHD had a role to play in upto 10% of their CKD-D patients. 70 Nephrologists (38%) actively prescribed this therapy, the rest although not prescribing it, still believed this to be a viable option. Nephrologists feared patient safety and medico-legal risk to the major challenges to prescribing this therapy. However all of them felt that these risks could be mitigated by adopting relevant processes. 60% patients chose HHD out of compulsion arising from immobility or transportation logistics, while the remaining made this as a lifestyle choice. Most of the patients who underwent HHD were from the middle class (60%). Most of the patients were funded by out of pocket payments (70%). Insurance covered this for only 17% patients. More than half of patients (55%) reported an improvement in their quality of life on HHD. Average monthly spend by patients was INR 55-60,000.The 3 year patient survival was 40%. Conclusions HHD is a viable option for patients with CKD in Developing economies. It enhances quality of life (QoL) and the increasing acceptance of this therapy by patients over the past 10 years as well as their outcomes, support this therapy to be a viable option. Risk perception about HHD by Nephrologists can be mitigated by process standardization and increased awareness among Patients, caregivers and Nephrologists.