Prevalence of antibodies to hepatitis C virus (anti-HCV) was determined in 190 adults (mean age 40.4 years; range 15 to 75) with end-stage renal disease (ESRD) who are on regular hemodialysis in the Nephrology Unit, Riyadh Central Hospital. The overall prevalence rate was 53.7% (48.7% and 61.0% in Saudi's and expatriates, respectively). These figures are considerably higher than the figures of 34.8% reported from hemodialysis units in Riyadh, 20% in Spain, 5.5% in Germany, and 1% in the United Kingdom. The possible reasons for the high prevalence of this marker of HCV in our hemodialysis unit are considered and suggestions made for its control.