Background: Serum soluble transferrin receptor (STfR) is a vital marker for iron status assessment in inflammatory conditions. Objective: evaluation of serum STfR usefulness in iron deficiency anemia detection in prevalent hemodialysis patients. Patients and Method: This case-control study included 80 end-stage renal disease (ESRD) patients on conventional hemodialysis (HD) divided into 40 patients with c-reactive protein (CRP)>10 mg/l, 40 patients with CRP<10 mg/l and 8 healthy controls. Serum STFR was measured for all patients and controls. Results: STfR can predict iron deficiency anemia in hemodialysis patients at cut-off value of 12.5 mg/l with an area under curve 0.949. The STfR was positive in 85% in patients with CRP<10 mg/l and 92.5% in patients with CRP>10 mg/l (P-value 0.288). Patients who have elevated STfR have a risk of 1.22 times to have iron deficiency anemia if CRP <10 mg/l (odds ratio: 1.22) and 3.14 times if CRP>10 mg/l (odds ratio: 3.14). There was a significant difference between patients with CRP<10 mg/l, CRP>10 mg/l, and control in hemoglobin and STfR level with P-value 0.0001 and 0.0001 respectively. Post Hoc analysis showed significant difference between patients with CRP<10 mg/l and CRP>10 mg/l in STfR p-value 0.0001 despite no significant difference in hemoglobin (p-value 0.642) and classic iron markers (s.iron, TIBC, TSAT) p-value 0.701, 0.192, 0.382 respectively. Serum STfR was negatively correlated with s.iron in patients with CRP <10 mg/l (r -0.372, P 0.018). Conclusion: Serum STfR is a sensitive and specific marker for iron deficiency anemia in hemodialysis patients, especially with high CRP.