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End-stage renal disease is associated with increased level of depression. Depression is associated with a reduction in the ability of people to effectively communicate in interpersonal settings. The interaction between end-stage renal disease patients and their physicians has important implications for the course of the treatment of this disease; however, there is limited research examining the influence of depression on general patient-physician communication. This study examines the association between depression and physician-patient communication in a sample of Hispanic end-stage renal disease patients. Participating patients filled out the Beck Depression Inventory and self-reported their feelings about meeting with physicians. Patients then met with a physician, and a nurse practitioner observed the interaction. Results indicate that depression was negatively associated with patients' self-reported perceptions of their readiness for the appointment (r =-.20) and with self-reported communication efficacy (r =-.19). Moreover, the nurse practitioner rated patients with depression as being significantly less likely (a) to ask for clarification (r =-.40), (b) to be engaged in the conversation (r =-.46), and (c) to be forthcoming with the physician (r =-.37). Results of this study have significant implications for communication between physicians and end-stage renal disease patients and for the influence of depression on patient-physician communication.