Background: end-stage renal disease (ESRD), is the last stage of chronic kidney disease. When your kidneys fail, it means they have stopped working well enough for you to survive without dialysis or a kidney transplant. Objective: it was to assess the pulmonary function in patients with ESRD after hemodialysis. Patients and Methods: Prospective study which was done in tertiary level care center.Thirty ESRD patients who were on hemodialysis regularly were studied. Results: The mean FEV1/FVC% which was observed in the patients of this study was 67.8±20.8% of the predicted value, after hemodialysis, the mean FEV1/FVC% increased up to 82.3±20.1% of the predicted value, and this increase was statistically significant with P value <0.006. The mean of the forced expiratory flow 25-75% (FEF 25-75%) of the studied patients pre-dialysis was 53.1±33% of the predicted value, after hemodialysis, the mean of the FEF 25-75% increased up to 58.3±34.6% of the predicted value and that was statistically significant with P value <0.05. The mean of the peaked expiratory flow rate (PEFR) was 47.8±31.7% of the predicted value and after hemodialysis, the mean PEFR increased to 52.1±30.9% of the predicted value and that was statistically significant with P value <0.05). Conclusions: pulmonary function tests decrease significantly among ESRD patients who undergo hemodialysis regularly pre and after the sessions of hemodialysis. Most ESRD patients were with abnormal pulmonary functions, mainly of a restrictive pattern.