Anti-PD-L1 (programmed cell death-ligand 1) agents, such as atezolizumab, have been approved for the treatment of different advanced cancers. However, no study enrolled end-stage renal disease (ESRD) patients, and to our knowledge, there are no significant published data about safety and efficacy of PD-L1 inhibitors in this population. Here, we report the first case of a male patient with metastatic urothelial cell carcinoma and ESRD on dialysis, safely treated with atezolizumab.