The 33-years-old young male was hospitalized due to dyspnea and edema. The patient was diagnosed with end-stage renal disease, hypertension and heavy proteinuria requiring long term dialysis treatment. Other possible differential diagnosis were excluded and eventually Fabry disease was confirmed through enzyme assay, genetic analysis and kidney biopsy. The purpose of this study emphasizes on the need to consider the possibility of Fabry disease on young male with unknown reason younger-onset kidney disease in addition to other causes of chronic kidney disease, such as DM, hypertension or chronic glomerulonephritis. Enzyme replacement therapy was administered as soon as possible to prevent pathological development of heart or brain. Furthermore, we also diagnosed other cases of Fabry disease in his family through Genetic Test and early treatments were provided. Therefore, we expected that Fabry disease will not be considered in clinical practice and early diagnosis with treatment could be provided to decrease the complication and disability rates.