Nearly 20% of Ontarians on maintenance dialysis are recent immigrants. Our population-level study found that recent immigrants are less likely than long-standing residents to receive physician-delivered palliative care in the last year of life. This may be due to language discordance between patients and their kidney care providers, as most recent immigrants come from regions where English is not the primary language. Receiving care in a non-primary language is associated with poorer health outcomes. However, it is unknown whether this affects use of palliative care at end of life in people on maintenance dialysis. Using population-level healthcare administrative databases, we will examine whether having a non-English primary language is associated with lower rates of physician-delivered palliative care in this population. Our findings could motivate efforts to provide language-concordant care and serve as the foundation for research aimed at improving palliative care access for marginalized linguistic communities.