This review article describes the evolution of dialysis technologies spanning the past few decades and discusses the current advancements in hemodialysis devices. These advancements aim to meet the growing global demand for hemodialysis through improved engineering and patient-centered developments that enhance treatment accessibility, automation and sustainability. This article aims to bring together hemodialysis hardware, its clinical utility and the philosophy underpinning it-aiming to improve outcomes, user experience and restore independence for patients with end-stage kidney failure undergoing dialysis care.