End-stage kidney diseases (ESKD) is considered a public health problem in both developed and emerging countries. This study aimed to assess the epidemiological profile of ESKD patients undergoing hemodialysis (HD) in Sidi Bel Abbes city. Methods: This retrospective, observational and descriptive study was conducted from January 2015 to December 2018 involving 698 patients in Renal replacement therapy, including 673 patients undergoing HD. Results: The prevalence of ESKD was 805.57 pmp. Regarding the epidemiological profile of HD patients, there was a slight predominance of males: 373(55.4%) vs. Females: 300 (44.6%); sex-ratio 1.24) (p < 0.001). The mean age was 57.43 ± 17.05 years. Patients included in age group 45-64 years were the most affected by ESKD (39.2%) and hypertensive nephropathy and diabetic nephropathy were the most frequent causes (34.5%) and (25.1%) respectively, followed by unknown causes (19.6%). Cardiovascular diseases were the major common comorbidities (58.5%) (p = 0.043). The mean duration on HD was 5 years. 140 deaths (20.8%) were registered, with males' predominance 61.4%. The causes of death were primarily cardiovascular (41.4%). Conclusion: Our findings showed alarming rates in ESKD prevalence and incidence in Sidi Bel Abbes city, representing a burden for the country, affecting especially the young population. This study represents the first comprehensive description of clinical and epidemiological profile of HD treated ESKD patients in this city. This would contribute establishing an ESKD index dedicated to this city and creating a Maghreb or even an Arabic registry aiming to ensure better management of this pathology.