Avoidance of dialysis-related morbidity, improvement in quality of life, and reduction of costs have been mentioned as advantages of preemptive kidney transplantation. However, this therapeutic option is underutilized. Previous studies assessing the patient survival benefit of preemptive kidney transplantation compared it with postdialysis kidney transplantation. These studies may have been subjected to lead-time bias. When comparing patient survival of preemptive kidney transplant patients with waitlisted dialysis patients, there is a clear patient survival advantage in favor of preemptive kidney transplantation. This benefit justifies encouragement of preemptive kidney transplantation.