Uremic pruritus is a common and intractable symptom in patients on chronic hemodialysis. It causes serious discomfort and skin damage, negatively affects the quality of life, and may be associated with sleep disturbance, inflammation, and higher mortality.The aim of the present study was to assess serum level of Fibroblast growth factor 23 [FGF 23] in patients with uremic pruritus undergoing hemodialysis to evaluate its role in uremic pruritus pathogenesis and evaluation of its clinical significance.The present study was conducted as a comparative cross-sectional study, study included 80 patients with end stage renal disease undergoing hemodialysis; 40 of them were suffering from uremic pruritus [Group A] and 40 patients were not suffering from it [GroupB]. All patients were recruited from the hemodialysis unit of Benha University Hospital between May 2017 and July 2018, All studied subjects were tested for serum level of endothelin-1 [ET-1] 1 in both patients groups using an ELISA technique.There was no significant difference of the serum level of FGF 23 regarding age, biochemical parameters and VAS score of pruritus. While, the duration of hemodialysis was significantly longer among group A patients [p 0.001].Fibroblast growth factor 23 may play a role in the pathogenesis of uremic pruritus and can be used as a sensitive biomarker in predicting uremic pruritus in chronic kidney disease patients undergoing hemodialysis.