Problem statement: The incidence of infectious diseases is increased in patients with chronic renal failure. Chronic renal failure severely influences the immune functions of the host. Approach: To evaluate the antitetanus immunity level in southern Iranian patients with end stage renal disease undergoing hemodialysis and to find its association with sex, age, blood hemoglobin and serum albumin, duration of dialysis. This cross sectional study was carried out on a total of 52 patients, who were on hemodialysis and 52 age and sex matched healthy individuals with without any underlying renal disease as a control group. Individuals in the both groups receiving antitetanus toxoid vaccine or immunoglubins a year prior to the study were excluded. The serum antitetanus IgG antibody levels were measured by an ELISA method. Results: Tetanus protected individuals in the patients and the control groups were 34.6 and 63.30% respectively. Of the evaluating factors just hemodialysis duration found to affect on tetanus immunity. Conclusion: Tetanus protected individuals in the patients group were significantly less than tetanus protected individuals in the control group (p = 0.011). Hemodialysis duration has significant effect on antitetanus immunity level.