Background <p>Although femoral vein catheters are less preferred than internal jugular vein catheters, they are still actively used as an alternative. However, limited studies have assessed whether the patency of femoral vein catheters differs according to the initial dialysis modality. We compared and analyzed femoral vein catheter outcomes according to the initial dialysis modality and clinical factors.</p> Methods <p>We retrospectively analyzed medical records of 279 patients (a total of 318 cases) who underwent femoral vein catheterization for hemodialysis from January 2019 to August 2023. We divided the patients into two groups according to the initial dialysis modality (hemodialysis group [<i>n</i> = 182] and continuous renal replacement therapy group [<i>n</i> = 121]) and analyzed catheter survival.</p> Results <p>We eventually included 303 cases of femoral vein catheterization for hemodialysis from 264 patients. Catheter survival did not differ significantly between the hemodialysis and continuous renal replacement therapy groups. Body mass index was associated with overall catheter survival. In the hemodialysis group, no significant factor was associated with catheter survival. However, in the continuous renal replacement therapy group, increased body mass index, age, and platelet counts were associated with low catheter survival.</p> Conclusion <p>Femoral dialysis catheter survival was not associated with the initial dialysis modality, and a high body mass index was associated with low survival rates of femoral dialysis catheters in patients who underwent continuous renal replacement therapy.</p> Clinical trial number <p>Not applicable.</p>