Background: Patients in end-stage renal disease (ESRD) were considered immunocompromised, especially those on hemodialysis (HD) procedure which seemed to produce alterations of the immune status. BK polyomavirus (BKV) was found to be an aggravating factor of renal failure, and interest in immunosuppression has increased due to BKV infection.Objective:This study aimed to investigate thepossible association between BKV with ESRD with and without dialysis. Subjects and Methods:A case-control study included 150 serum samples collected from 50 patient with ESRD on dialysis,50 without dialysisand50 apparently normal subjects with normal renal function as control.Quantitative Real time PCR(RT-PCR) was done for detection of BKV viral load.Results: twenty (40%) out of the 50 dialysis patients were positive for BKV by RT-PCR and, eight (16%) were positivein patients without dialysis, while none of the controls was positive. There were highly significant differences (p<0.001)on comparing between the mean viral load in patients who had dialysis was 2.16X10 5 copies/ml of BK viralDNA, and those without dialysis1 22X10 3 copies/ml of BK viralDNA. Conclusion:These results strongly indicated the role of BKV infection (quantitatively and qualitatively) in ESRD particularly in patients with dialysis; this put dialysis as a potential risk factor for BKV infection in those patients.