Background: End stage renal disease affects all aspects of life of the patients and their caregivers. Caregivers receive little support than patients for that, coping strategies are important to solve difficult situation and cope with burden. Aim: Assess caregiving burden and coping strategies of caregivers caring for elderly with end stage renal disease. Design: A descriptive research design was used in this study. Setting: This study was conducted at hemodialysis unit in Mansoura University Hospital. Subjects: A purposive sample of 150 caregivers who met the inclusion criteria. Tools: Three tools were utilized in this study; Structured interview schedule, Zarit burden interview and Jaloweic coping scale. Results: 44.0% of the studied caregivers had moderate level of burden. The mean of affective oriented coping strategies was 25.49 ±7.77 while, the mean of problem oriented coping strategies was 25.42 ± 8.30.There was negative significant correlation between caregiver burden and using of affective oriented and problem oriented coping strategies (p=0.01*& p=0.004*respectively). Conclusion: The caregivers' burden is common among family caregivers who care for elderly patients with end stage renal disease undergoing hemodialysis. Caregivers have been found to be using affective oriented coping strategies more than problem oriented coping strategies.