Introduction: Patients under hemodialysis treatment face various physical and mental problems. One of the basic principals in prevention of complications in these patients is education. But education, solely, does not result in improve hemodialysis control situation, therefore, more attention should be paid to follow-up. Currently, by coming new communications systems and telemedicine, using them, such as follow-up methods, is inevitable. This study aimed to determine the effect of self-care education with telephone follow-up on the self-efficacy level in hemodialysis patients. This study is a quasiexperimental study conducted from October 2013 to March 2014 recruiting 60 hemodialysis patients referring to dialysis ward, Motahhari Hospital, Jahrom, Iran. The data collection instruments included demographic questionnaire and SUPPH (Strategies Used by Patients to Promote Health). The data were collected in two steps, before and two months after training intervention. Questionnaires were completed in interview method by research assistance. At the first, participants took part in 5 consecutive one-hour training instructions and then they received an instruction booklet. Then 60 patients were randomly assigned into two groups including self-care training group (30 patients) and self-care training with telephone follow-up group (30 patients). The self-care training with telephone follow-up group was received 24 phone calls (three times a week during the first and second months after the instruction) in addition to receiving 5 instructional sessions and instruction booklet. Phone call schedule was given in writing to the patients after the fifth session of instruction. The duration of each call was 20 minutes, which could also vary according to the patients' needs. The data were analyzed by SPSS version 20, Chi-square, Paired t and Independent t tests. There were no statistically significant differences in demographic variables between the groups. Pre-test mean scores for self-efficacy did not differ between the groups. There was a significant difference between the self-care training with telephone follow-up group and selfcare training group in terms of pre-to post-intervention changes in overall self-efficacy scores, stress reduction, and decision making (p<0.001). Our study demonstrates that a combination of self-care training and telephone follow-up improves self-efficacy in hemodialysis patients. self-care training with telephone follow-up should be considered in hemodialysis centers to assist patients with the management of their health-related problems.