Background: Hemodialysis (HD) is a viable and widely prescribed therapeutic option for older adults with End Stage Renal Disease. Even though anxiety is one of the most common difficulties that HD patients face and frequently linked to depression, a lower perceived quality of life, and a lack of therapeutic adherence. As non-pharmacological therapies are safer to use in the management of geriatric patients' disorders, implementing of such approaches to reduce anxiety levels is a worthwhile goal for the gerontological nurse. Aim: This study aimed to determine the effect of lavender oil inhalation versus acupressure on anxiety level of geriatric patients undergoing hemodialysis. Design: A quasi-experimental research design was utilized. Setting: Hemodialysis Unit of Damanhur National Medical Institute, El-Beheira Governorate, Egypt. Subjects: Sixty-six geriatric patients were randomly assigned to three equal groups (n=22 in each group) lavender oil inhalation, acupressure, and control group. Tools: Four tools were used: Quick Smell Identification Test, Short Portable Mental Status Questionnaire, Geriatric Anxiety Scale (GAS), and Hemodialysis geriatric patients' Socio–Demographic and Clinical Data Structured Interview Schedule. Results: The mean geriatric anxiety scale scores were decreased post interventions in the lavender aromatherapy group (from 29.8± 5.0 to 19.7±5.3) as well as in the acupressure group (from 27.1 ±3.6 to 18.3± 6.4, with a highly statistically significant difference (p = 0.001). Conclusion: Both lavender aromatherapy and acupressure were effective in reducing anxiety in geriatric patients undergoing hemodialysis, with lavender aromatherapy having a relatively higher effect than acupressure. Recommendations: Encourage nurses to use lavender aromatherapy inhalation and acupressure as a non-pharmacological approach to reduce patient anxiety and improve the quality of nursing care