Context: Chronic kidney disease is an increasing health problem worldwide and in its final stage (stage V) can only be treated by renal replacement therapy, mostly hemodialysis. Hemodialysis has a major influence on the everyday life of patients and many patients report dissatisfaction with treatment. Objectives: To study the clinical profile of patients with ESRD undergoing hemodialysis and to find out possible etiology which may have led to ESRD in these patients? Settings and Design: This is a prospective, observational study carried out in a tertiary care hospital. Methods and Material: 50 patients, older than 15 years who were on maintenance hemodialysis in this hospital on outpatient basis for more than 3 months were selected for the study. Detailed clinical history, general and systemic examination of all patients was performed. Two manifestations pertaining to each system was taken for study. Statistical Analysis Used: Descriptive as well as inferential statistics were used to analyze the data. Results: Most patients were in the age group of 51-60 with male: female ratio of 1.77:1. Diabetes and hypertension were most common causes for ESRD. Anemia and electrolyte disturbances like hyperkalemia along with hypocalcemia, hyperphosphatemia and hyperuricemia have common associations with ESRD. Conclusions: Lack of health awareness and lack of regular health checkup in general population is one of the culprit factor for progression of renal disease. Health awareness in general population may decrease the incidence of ESRD or postpone the development of ESRD.