The main treatments for end-stage renal disease (ESRD) include dialysis and palliative treatment, and the former has obvious survival advantages over the latter. However, it is not clear whether there are differences in symptom clusters associated with the two treatments. This article makes a retrospective analysis of the symptom clusters associated with dialysis and palliative treatment for elderly ESRD patients and reviews the concepts related to symptom cluster, symptom associated with the two treatments in all dimensions, and the comparison between the symptom clusters, with a view to providing reference for clinical diagnostic and therapeutic decisions and the related research on the symptom cluster in the elderly ESRD patients.