A new article published in Seminars in Dialysis reported that for patients who require hemodialysis, beta blockers offer opportunity as well as challenge in the treatment of cardiovascular disease. This article discussed that beta blockers directly alleviate sympathetic overactivity that links chronic kidney disease with cardiovascular sequelae. The authors stated that trial and observational data can help guide the use of these medications in patients receiving hemodialysis. This review article highlighted the reasons behind considering beta blockers for patients receiving hemodialysis, discussed the barriers to their use, and provided specific evidence-based recommendations for beta blocker use in patients with heart failure, hypertension, ischemic heart disease, and arrhythmia.