ResultsAmong the 81 HD patients studied (49 males + 32 females) aged 50.6 ± 12.7 years, HRQOL scores were poor in all domains and subscales. The mean total score was 47.2 ± 25.2, mean Physical Health Composite (PHC) = 35.57 ± 7.34 and mean Mental Health Composite AbstractThis cross-sectional descriptive study was carried out at the hemodialysis unit of Karmouz Health Insurance Hospital, Alexandria, Egypt. The study was conducted on adult End-stage renal disease (ESRD) patients maintained on regular hemodialysis treatment for ≥1 year. Aim was to assess self-perception of ESRD patients undergoing regular Hemodialysis (HD) of their health-related quality of life (HRQOL) and explore resulted scores using kidney disease quality of life short form 36 instrument (KDQOL SF-36). A total of 81 eligible patients joined the study (49 males and 32 females). Aged 50.6 ± 12.7 years. Results showed that HRQOL of HD patients was very poor in all domains. The mean total score was below 50 (out of 100 point) with mean Physical Health Composite (PHC) = 35.57 ± 7.34 and mean Mental Health Composite (MHC) = 36.76 ± 10.22. In general, scores were relatively higher in males, younger age groups, high educational level, employed and/or higher family income. Regarding clinical prolife, this study showed that scores were lower among patients suffering anemia, dyslipidemia, hypoalbuminemia and/or those with comorbidities. Scores for general health survey were significantly lower in anemic patients (with hemoglobin level <11g/dL). Working patients had significantly higher scores than non-working or retired. The study also showed that employment was the only significant predictor for total HRQOL score in a multiple linear regression model was designed to predict total score, while controlling for hemoglobin level, age, duration of being on HD (p = 0.028).