Background: End stage renal disease is a major public health problem in developing countries. Purpose: To determine the effect of intradialytic exercises on dialysis efficacy and blood pressure among patients undergoing hemodialysis. Setting: The hemodialysis unit of Menoufia University Hospital. Sampling: A consecutive sample of 50 adult hemodialysis patients were selected and divided alternatively into two equal groups: 25 patients for each group (study - control). Instruments: Four instruments were used for data collection: Structural interview questionnaire, bio-physiological instrument, and observational checklist. Results: There was a reduction in mean urea one month after intervention and mean of blood pressure (128.48 ± 9.70 Vs 134.55 ±3.78). Conclusions: Intradialytic exercises were effective in improving dialysis efficacy and blood pressure scores for patients undergoing hemodialysis. Recommendations: A health teaching program about intradialytic exercises should be carried out for all hemodialysis patients to improve dialysis efficacy and blood pressure. Besides, a colored booklet should be available and distributed to all hemodialysis patients.