End-stage kidney disease is a major public health problem worldwide, so dialysis water must be strictly monitored to avoid transfer harmful elements to the patient. Dialysis patients are exposed weekly to more than 40 times water than healthy individual's drink. The main aim of present study to develop a dialysis water safety plan (DWSP) appropriate to the water quality and conditions of each dialysis unit to protect patients from dialysis water contaminants. Analysis study carried out in 15 hospitals in Cairo. 180 samples were taken from drinking water which feed dialysis centres before treatment and 325 samples after treatment from dialysis water units (24 units) monthly over a 12-month period. Microbiological and chemical analysis were performed according to the American standard methods for the examination of water and wastewater. All 180 drinking water samples were applicable to Egyptian and WHO limits. But hemodialysis water results were not applicable chemically in 0.3% samples for ammonia and residual free chlorine, 1.5% nitrites, 3.69% calcium, 4% magnesium and 0.6% for increasing total dissolved solids. While microbiological analysis for dialysis water samples were not applicable for total coliforms in 2.7%, 1.8 %E. coli, 4.6% Pseudomonas aeruginosa, 2.15% Streptococcus faecalis, heterotrophic plate count showed increase by 3.3%, 3.6% at 35⁰C and 22⁰C respectively.Therefore, it is necessary to have a DWSP within each unit according to its components and the quality of the water it feeds, and to develop an understanding of the unit's system and its ability to provide safe dialysis water.