Dietary therapy is a critical component of the hemodialysis prescription. The purpose of this qualitative study was to investigate and describe the lived experience of dietary restrictions in English-speaking, West Indian (WI) adults on maintenance hemodialysis. A phenomenological approach using open-ended interviewing strategies was employed. The sample consisted of five patients who received their treatment in the chronic hemodialysis unit at an inner-city hospital. Following satisfaction of delimitations, each subject had a tape-recorded interview with the researcher that was immediately transcribed by a medical transcriber. Qualitative methods were used to analyze and interpret all data from which the following themes emerged: (a) diet is a major problem; (b) patients adapt by trial and error; (c) WI foods are not listed in the renal failure diets; (d) patients believe that staff lack sufficient knowledge about WI diet and foods; (e) patients believe that eating an American renal diet made them feel worse; and (f) both staff and patients need information on WI foods. The current food list available to the WI hemodialysis patient is insufficient. There is a knowledge deficit regarding WI dietary patterns and their modification for patients on hemodialysis. Further collaborative research is clearly indicated. The findings from this study will add knowledge and understanding in caring for the renal failure population as their numbers continue to increase within this ethnic group.