Background: The present study aimed to evaluate the effect of cold dialysis solution on the sexual dysfunction of patients with chronic renal failure undergoing hemodialysis. Methods: This randomized clinical trial was conducted with a before and after parallel design among 60 hemodialysis patients diagnosed with sexual dysfunction. The selected subjects were randomly allocated to the two groups of experimental and control (30 per each). Patients in the experimental and control groups underwent hemodialysis for one month using 35.5°C and 37°C dialysis solutions, respectively. Following the procedure, male and female sexual function was assessed in the study groups. Data were collected using the International Index of Erectile Functions, the female sexual function index (FSFI), and a demographic questionnaire. Data analysis was performed using Chi-square, Fisher's exact test, Mann-Whitney U test, t-test, paired t-test, and Wilcoxon test at 95% confidence interval. Results: No significant difference was observed between the experimental and control groups regarding male sexual function before and after the intervention (P > 0.05). However, the Mann-Whitney U test indicated a significant difference in the female subjects’ arousal in the experimental group before (3.68 ± 0.38) and after the intervention (3.98 ± 0.46; z = 2.216; P = 0.027). Conclusions: Cold dialysis solution could only increase the sexual arousal of the women in the experimental group, and no changes were observed in other sexual function domains of the male and female patients. Given the short duration of our intervention, it is recommended that further longitudinal studies be performed on larger cohorts of patients in different geographical regions.