Background Data on the functional status (FS) of patients on maintenance haemodialysis (MHD) and their caregiver burden (CGB) in SSA where patients have fewer weekly dialysis sessions and pay out-of-pocket for dialysis-related costs is sparse.  Objectives To assess the functional status of Patients on MHD in Cameroon, and the burden of their Caregivers, and to determine the factors associated with functional status impairment (FSI), and high caregiver burden (HCGB).  Methods We consecutively enrolled patients on MHD at the Bamenda Regional, and Yaounde General Hospitals over a period of 3 months. We included patients on MHD for ≥ 3 months and their caregivers. Patients and/or caregivers with documented dementia were excluded. Through a face-to-face interview, FS was assessed by combining self-reports of 8 instrumental, and 5 basic activities of daily living using the Lawton-Brody and the Katz (LBKQ) scales, and CGB was assessed using the Zarit Caregiver Burden Scale (ZCGBS). We defined functional status impairment (FSI) as a score ≥ 1 on the LBKQ scale, and a high CGB as a ZCGBS score ≥ 41. Data were analysed using the IBM-SPSS version 26.0 Results A total of 115 patients and 51 caregivers (CGs) were enrolled. The mean age of the patients was 46.9 ± 15.0 years, and 54.8% (n = 63) were males, whereas the mean age of the CGs was 38.30 ± 13.10 years with 72.5% (n = 39) being females. A total of 90 (78.3%) patients had functional status impairment (FSI), while 78.4% (n = 40) of caregivers experienced a burden (41.2% classified as moderate, and 37.2% as high). Anaemia (aOR = 9.2, CI = 3.9–29.4, p < 0.001), and a high daily pill burden (aOR = 4.4, CI = 1.1–18.5, p = 0.043) were independently associated with FSI, while age of caregiver ≥ 45 years (aOR 9.9, CI = 1.7–56.8, P = 0.01) was independently associated with a high CGB. There was a strong positive correlation between FS and CGB. Conclusion There is a high prevalence of functional status impairment in patients on maintenance haemodialysis in Cameroon, resulting in high a physical and psychological burden on their caregivers.