Introduction: Long-term hemo dialysis and kidney transplantations are the most common treatment for kidney failure. Regarding the increasing demand of these patients to receive therapeutic services, cost-effectiveness of these methods are compared. 

Methods: This Cross-Sectional research was done to compare cost- effectiveness of long - term hemo dialysis and kidney transplant using Dali index and patients' medical records. Research population are kidney patients referring to Shahid Hasherminejad Hospital in 1378.

Findings: In this survey expenses of the year 1378 were tallied. Findings show that kidney transplantation expenses were 38% and 18.5% of long - term hemo dialysis for male and female patients, respectively. In Dali Scale, effectiveness of kidney transplantation was 7 times more than long-term hemo dialysis. Overall, cost - effectiveness of kidney transplantation is 8 times more than hemo dialysis.

 Results: The average costs of the treatment period in chronic dialysis method is four times more than kidney transplantation. Effectiveness according to Dali index , in kidney transplantation method for patients up to 54 years of age is more than chronic dialysis method. In comparing costs, transplantation method for all comparable age groups effectiveness of is 3 to 14 times more than dialysis method.