Background: The prevalence of patients with end stage renal disease is increasing. Pulmonary diseases have been suggested to be more common in end stage renal disease patients on haemodialysis. Aim of the work: It was to evaluate the pulmonary function state and the prevalence of pulmonary disorders in hemodialysis patients. Subjects and methods: A retrospective study on 61 patients with chronic renal failure on regular Hemodialysis at El-Hussein University Hospital, Al-Azhar University. Results: The study included 61 chronic renal failure patients fulfilling the inclusion criteria with mean age 54.23 ± 10.07 years that ranged from 26 – 77 years old. Females represent 62.3%, about one third of patients (31.15%) were smokers and slightly more than half of them living in rural areas Pulmonary functions were affected in nearly half of them (restrictive 27.87%, obstructive 14.75% and mixed 6.56%). Variety of pulmonary disorders coexisted in about 69% of patients with 22.95% suffered from pleural effusion, 16.39% had TB, 11.48% and 8.20% developed pulmonary embolism and pulmonary edema respectively and finally community acquired pneumonia and uraemic asthma. Conclusion: Respiratory disorders especially restrictive lung pattern, pleural effusion, pneumonia and pulmonary embolism were associated with end stage renal disease on regular hemodialysis. Recommendation: Any patient with chronic renal failure, especially patients on regular hemodialysis should be observed early for detection of any pulmonary diseases or disorders.