Abstract: Home hemodialysis is used by 1.0% of dialysis patients with end-stage renal disease in the United States. Patients undergoing home hemodialysis have lower morbidity and mortality rates than those using center-based hemodialysis or home peritoneal dialysis. We report the first patient on home hemodialysis with Staphylococcus lugdunensis endocarditis and review the unusual properties of this aggressive coagulase-negative Staphylococcus. We report a 45-year-old man who developed S. lugdunensis infective endocarditis while on home hemodialysis. Endocarditis complicating home hemodialysis is rare, and endocarditis complicating home hemodialysis due to S. lugdunensis has not been previously reported. S. lugdunensis is a coagulase-negative Staphylococcus that may cause rapid onset of symptoms and rapid destruction of tissue. Its incidence may be underestimated, and its presence may be missed because some clinical microbiology laboratories do not routinely speciate coagulase-negative staphylococci isolated in culture from clinical specimens.