Background: Anemia is a common complication of endstage renal disease despite sufficient iron stores. That is mainly due to the effect of chronic inflammation. Aim of Study:Our study investigated the effect of using a know drug used in intermittent claudication (named pentoxifylline) as an adjuvant to ESA to improve anemia of hemodialysis patients. Patients and Method:Fifty hemodialysis anemic patients were included. They were assigned to two groups of equal numbers. Oral Pentoxifylline 400mg once daily was added to the treatment group which was compared to the control group over a six months period regarding hemoglobin, hematocrit, serum albumin and CRP. Results:We found no significant difference in hemoglobin or hematocrit between the two groups at the end of the study. However serum albumin was significantly higher in the treatment group (4.2±0.3) than the control group (3.8 ±0.4) p<0.001 at the end of the study. In addition, CRP was significantly lower in the treatment group (8.8 ±5.4) versus (17.1 ± 13.3) for the treatment and control group respectively; p=0.005).Conclusion : Pentoxifylline had a significant effect in improving the chronic inflammatory state but its use in improving anemia of hemodialysis patients still needs further research.