Natural catastrophes disproportionately affect ill and socioeconomically disadvantaged populations. Patients with end-stage renal disease are particularly vulnerable. Recent events have led to the creation of national and international institutions that provide assistance before and during such tragedies. Disaster planning by dialysis centers, providers, and patients can also help improve outcomes during a catastrophe. Greater governmental resource allocation is needed to adequately prepare for disasters and to help the disadvantaged during the relief and recovery phases.