Background: Peripheral arterial disease (PAD) is common in patients with end-stage renal disease on regular hemodialysis. Neutrophil to lymphocyte ratio (NLR) is considered an indicator of the severity and extent of systemic inflammation and atherosclerosis in patients with renal and cardiovascular disorders. Objective: To assess neutrophil to lymphocyte ratio as a predictor of peripheral arterial diseases in regular hemodialysis patients. Patients and Methods: This cross-sectional study was carried out at Hemodialysis Unit of Al-Hussein University Hospital over a period of six months from January to July 2020, and conducted on 40 hemodialysis patients. Demographic data and clinical information were recorded. Laboratory data including CBC, calcium, phosphate, albumin, cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, iron profile were evaluated. The ankle-brachial index was measured in all patients. PAD was diagnosed if ankle-brachial index (ABI) ≤ 0.9. Duplex ultrasound for arterial system of both lower limbs was done for patient with ankle-brachial index≤ 0.9. Results: There were 29 males (72.5%) and 11 females (27.5%). The mean age of all patients was 43.2 ± 10.3 years. There were 7 diabetic (17.5%) patients, and 27 hypertensive (67.5%) patients. Regarding CBC, the mean of white blood cells (WBCs), neutrophils, lymphocytes, NLR, hemoglobin (Hb) and platelets (PLT) were 6.5 ± 1.7 (x10³/ul), 4.3 ± 1.5 (x10³/ul), 1.74 ± 0.53 (x10³/ul), 2.73 ± 1.3, 10.8 ± 2.3 (g/dl), and 234.7 ± 95.9 (x10³/ul) respectively. Regarding lipid profile, the mean of total cholesterol, high density lipoprotein (HDL) and triglycerides were 214.7 mg/dL, 41.9 mg/dL, 172.2 mg/dL, respectively. Regarding serum albumin, corrected serum calcium (Ca), serum phosphorus (PO4), serum Ca X PO4 product, and parathyroid hormone (PTH), the means were 3.99 ± 0.5 (g/dl), 8.3 ± 0.6 (mg/dl), 5.22 ± 1.1 mg/dl, 43.7 ± 11.2 and 722.1 ± 477.7 (ug/ml) respectively. Regarding to ABI, there were 13 patients (32.5%) ≤ 0.9, while there were 27 patients (67.5%) > 0.9. Conclusion: Neutrophil-lymphocyte ratio (NLR) could be considered as a predictor of peripheral arterial diseases (PADs) among regular haemodialysis patients.