The effect of anabolic steroid therapy on anemia in 13 women with and without kidneys undergoing chronic hemodialysis for renal failure was investigated. All but one of the six patients with kidneys demonstrated a noticeable increase in hematocrit level (6.4% to 14.6%). Of the anephric women, four of the seven also showed hematocrit level elevations, but these were less remarkable (3.1% to 6.4%). A majority of patients demonstrated increments in weight and serum creatinine measurements but no definitive alteration in serum blood urea nitrogen levels. The androgenic effects of nandrolone decanoate were minimal and well tolerated. We conclude that anabolic steroid therapy is effective in ameliorating the anemia of women undergoing hemodialysis, if given in a dose that produces minimal and tolerable untoward effects.