Water treatment is important for haemodialysis patients who are exposed to large volumes of water directly through their bloodstream. Reverse osmosis (RO) is commonly used to treat water for haemodialysis as it removes contaminants, bacteria and endotoxins. Proper design, monitoring and maintenance of the RO system is required. Storage tanks must be designed to prevent bacterial growth and reject water can be recycled to reduce wastage. Regular testing is needed to ensure water quality meets Association for the Advancement of Medical Instrumentation standards to protect patient safety.