This study examined epidemiologic patterns and time trends among male patients with Hispanic surnames in the Medicare End-Stage Renal Disease Program and compared US Hispanics with non-Hispanic Blacks and Whites. Male Hispanics had substantially higher proportions of end-stage renal disease attributed to diabetes than did Blacks and Whites. There were notable regional differences among Hispanics. Between 1980 and 1990, the incidence of treated renal failure among Hispanics increased more than that among Blacks or Whites. The increasing number of Hispanics in the United States with end-stage renal disease emphasizes the importance of explicit health evaluations and prevention strategies for Hispanic populations.