Background: Maintenance hemodialysis is considered the main form of treatment in patients with end-stage renal disease. So, vascular access is the major determinant for successful hemodialysis. Permanent vascular access nursing care is vital to maintain easy cannulation and sufficient blood flow which is considered as Achilles heel for hemodialysis patients. Aim of the study: To assess the nurses' knowledge and practices regarding permanent vascular access care among patients on hemodialysis. Research design: A descriptive cross-sectional research design was used. Setting: Hemodialysis unit in Itay-Elbaroud General Hospital affiliated to El-Beheira Health Directorate, Ministry of Health and Population, Egypt. Subjects: Included all nurses (N=67) who were involved in providing direct care for patients with permanent vascular access. Tools of data collection: Two tools were used: Tool (I): Assessment of Nurses' Knowledge Related to Permanent Vascular Access Questionnaire, Tool (II): Nurses' Practices Regarding Permanent Vascular Access Care Observational Checklist. Results: The study showed that (61.7%) of nurses had poor overall nurses' knowledge, and (76.7%) of them had incompetent nurses' practices regarding permanent vascular access care. In addition, a highly statistically significant weak positive correlation was found between nurses' practices and their knowledge levels; where (p<0.001) and (r=0.476). Conclusion: Nurses had poor knowledge and incompetent practices regarding permanent vascular access care. Recommendations: Implementing updated pre-service and periodic in-service programs to the hemodialysis nurses to improve their knowledge and practices regarding permanent vascular access care throughout hemodialysis session, and its related complications. Besides, including nursing care of permanent vascular access throughout hemodialysis session in nursing curricula.