E nd stage renal disease (ESRD) is one of the diseases most commonly found among elderly people. At present, there is a growing tendency for the disease to occur more frequently worldwide, including in Thailand. According to an occurrence report in Thailand, it was found that the number of ESRD patients had increased from 410.90 people in 2007 to 522.80 people in the year 2009. Later, the number increased from 10,181 people in 2012 to 12,800 people in the year 2013. Furthermore, it was predicted that the number of elderly patients with ESRD would increase up to 34, 594 in the year 2017. 1 This is a significant problem which is likely to become even more serious in the near future. ESRD is the condition in which the nephron is gradually destroyed until it loses function. The deterioration in the functioning of the kidneys, namely filtration, tubular reabsorption, waste reduction, excretory system, and hormone production, leads to the end stage or the so-called ESRD. When chronic kidney disease (CKD) progresses to ESRD, the filtration rate will become lower than 15 ml/min/1.73 m 2 of the body surface area for more than a period of three months. 2 This can weaken the excretory system, water balance, pH balance, and the production of crucial hormones. As the kidney function decreases, this contributes to significant signs or symptoms e.g. hypertension and heart failure in the cardiovascular system; asthma, dyspnea due to fluid overload, pulmonary edema, and pneumonia in the respiratory system; and nausea and vomiting and anorexia in the digestive system. In addition, it will also affect the nervous system due to the accumulation of uremia and the imbalance of water and electrolytes. 3 When kidneys do not function Abstract OBJECTIVE: This research aimed to study the resilience of elderly patients with end stage renal disease (ESRD) and its related factors towards hope, self-efficacy, optimism, and family relationships RESEARCH TOOLS AND METHOD: This present study is a piece of descriptive correlation research. The samples included ninety-seven elderly patients who were diagnosed with ESRD and treated at the Outpatient Department, Chronic Kidney Disease and Artificial Kidney 1 Clinic, Sakaeo Crown Prince Hospital. The data were collected using interviews, and they were then analyzed with descriptive statistics and Pearson's Correlation Coefficient. RESULTS: The findings revealed that the studied samples had moderate resilience (71.1%). A significant positive correlation was found between resilience and hope (r = 0.536, p < 0.001) family relationships (r = 0.449, p < 0.001) and self-efficacy (r = 0.349, p < 0.001). While, optimism (r = 0.289, p = 0.004) was found as a low positive correlation to resilience among the elderly people with ESRD CONCLUSION: Among the elderly patients with ESRD in this study, a significant positive correlation was found between resilience and hope, self-efficacy, optimism, and family relationships. Therefore, nurses or healthcare professionals who are taking care of elderly patients with ESRD...