Purpose Hope and death anxiety as the important sources of adjustment can affect the attitude, health status and quality of life in patients undergoing hemodialysis. Hopelessness and death anxiety are considered as the important factors in patients undergoing hemodialysis, because these can avoid non-adherence and increase mortality rate. This study aims to investigate the effect of the cognitive–behavioral intervention on hope and death anxiety in patients undergoing hemodialysis. Design/methodology/approach In this randomized controlled clinical trial, 84 patients undergoing hemodialysis were included, who were then divided into two groups as the cognitive–behavioral intervention group (n = 42) and the control group (n = 42). The experimental group received eight sessions of individual chair-side cognitive–behavioral intervention. To measure the hope level and death anxiety, Hearth Hope Scale and Templer’s Death Anxiety Scale were used as tools once at the beginning and once at the end of the study. Findings The mean scores of the hope levels in the intervention group significantly improved compared to the control group. Furthermore, the mean scores of the death anxiety levels significantly decreased in the intervention group compared to the control group. Originality/value Cognitive–behavioral interventions are significantly effective on promoting the level of hope and decreasing the level of death anxiety in patients undergoing hemodialysis. Therefore, applying this psychological intervention to design the individual education programs is recommended.