All 126 End-Stage Renal Disease (ESRD) patients who entered dialysis between 1971 and 1981 at the Harlem Hospital Center, New York City, were separated into those who had participated in a patient support group and those who had not done so. Patients who engaged in the group activities survived considerably longer than non-participants. Family history of renal disease, psychiatric illness, blood urea nitrogen (BUN), and creatinine were also related to survival, but, education, religion, marital status, and age were not. When 13 psychosocial and physiological covariates were controlled for in a Cox proportional hazard analysis, the group participation effect remained substantial.