Background: Many hemodialysis patients experience fatigue as a result of not achieving dialysis adequacy.Purpose: This study was designed to determine the effect of intradialytic range-of-motion exercises on dialysis adequacy and fatigue in patients undergoing hemodialysis.Methods: In this two-arm experimental study with repeated measures, participants were allocated to treatment (n = 25, 23 completed) and control (n = 25, 24 completed) groups using computerized simple random sampling. Participants in the treatment group performed 30-minute weekly intradialytic exercise sessions in addition to receiving standard care, whereas those in the control group received standard care only.Results: Fatigue and dialysis characteristics were reported at baseline, at the midpoint (end of Week 4), and at the end of Week 8. Whereas mean Kt/V (dialysis adequacy) and urea reduction ratio increased and the fatigue level decreased in the treatment group, these variables did not change in the control group. Significant mean differences in Kt/V, urea reduction ratio, and fatigue between the groups were observed at the end of Week 8.Conclusions: Intradialytic range-of-motion exercises are recommended for patients undergoing hemodialysis to increase dialysis adequacy and reduce fatigue.