Tunneled cuffed dialysis catheters (TCCs) are increasingly used as temporary or permanent vascular accesses for hemodialysis. The aim of this study was to compare the rate of complications according to the catheter location and to identify which factors are predictive of catheter-related complications (bacteremias, tunnel infections, thrombosis and dysfunctions) implying the removal of the catheter. Between December 1998 and November 2007, 323 dialysis TCCs (278 ASHsplit and 41 Tesio catheters Medcombe®, 4 permcath Tyco ®) were inserted in 248 patients (226 jugular; 48 subclavian and 49 femoral catheters). The femoral site was chosen generally because of thromboses of thoracic sites. After censoring for elective removal (fistula matured, transplantation, peritoneal dialysis), functional catheters and death with a functional catheter, catheter median survival time was significantly shorter for femoral versus thoracic catheters (309 vs 822 days, log rank 7.75, p =0.006). At three months, catheter-related complications requiring catheter removal with femoral and non-femoral catheters were respectively 22% and 14%. Using a Cox proportional hazards model, femoral location and age were significantly associated with a higher risk of non elective catheter removal. Particularly, the hazard ratio of non elective catheter removal for the femoral location was 3.01 (p=0.001). Femoral dialysis TCCs are associated with a higher rate of complications than jugular and subclabvian ones and should be inserted preferentially over the short term and when no other options are available.