Background: Hyperuricemia was found to be associated with hypertension, coronary heart disease, metabolic syndrome and chronic kidney disease. However there are no specific data about the relationship of uric acid to cardiovascular disease and mortality in ESRD patients on chronic hemodialysis.      So, we aimed to study the impact of hyperuricemia on cardiovascular system in chronic kidney disease and in ESRD patients on regular hemodialysis Patients and methods: This study included 100 patients in Ashmoun hospital, nephrology department. Patients were chosen and divided into two groups: Group A, 50cases with chronic kidney disease and Group B, 50cases of ESRD on regular hemodialysis. All cases were subjected to full clinical examination, measurement of eGFR, laboratory tests for blood urea, serum creatinine and serum uric acid and ECG. Results: Serum uric acid was significantly higher in dialysis group than CKD group (p<0.01). There was a highly significant correlation between uric acid and both systolic and diastolic blood pressure in Group A (all p values <0.01). Also, there was a significant correlation between serum uric acid and eGFR (p<0.05).No significant difference found between Group A and group B as regards ECG findings (p>0.05). Conclusion: In cases of CKD uric acid is involved in the pathogenesis of renal failure and hypertension. In patients with ESRD, hyperuricemia is not a risk factor for the development of cardiac disease; but it shows reversed epidemiology and becomes a marker of good nutritious status. Further studies should be done on wider scales to evaluate the impact of hyperuricemia on cardiovascular system in hemodialysis patients.