Background: Platelet / lymphocyte ratio has recently been investigated in different clinical conditions associated with hemodialysis and its association with other diseases has been assessed. The purpose of the study was to assess platelet lymphocyte ratio as a predictor of erythropoietin resistance in hemodialysis patients. Methods: The study population consisted of 60 hemodialysis patients, who were subdivided into two groups according to the response to erythropoietin stimulating agents (ESAs) .treatment. Group 1 included 30 patients treated with ESAs with good response to it and group 2 included 30 patients treated with ESAs but with resistance to it. The platelet/ lymphocyte ratio was calculated for each patient and compared between both groups. Results: Platelet lymphocyte ratio of group 2 was significantly higher compared to that of group 1 (P=0.001). Conclusion: PLR is a useful parameter to predict erythropoietin resistance in hemodialysis patients.