Nephrologists in India have embraced providing complete care to their patients and recognize the benefits of coordinated care. This review describes the practice of interventional nephrology in India. Even though the benefits of using tunneled catheters over nontunneled catheters are well recognized, the use of nontunneled catheters is preferred, primarily because of financial constraints and the lack of training facilities. Arteriovenous fistulas (AVFs) are the most common form of dialysis vascular access, often created by nephrologists. Upper arm AVF and arteriovenous grafts are uncommon. The implementation of surveillance tests and elective endovascular interventions on arteriovenous accesses is limited in India, compared to being a routine practice in the United States. The clinical experience from a center in Southern India is described here to show the current state of procedural nephrology practice in India.