Background: Uremic pruritus is a common symptom in patients with end-stage renal disease who are undergoing maintenance hemodialysis. This symptom is frequently refractory to most treatments, and is associated with substantial medical, psychological, and social disturbances in patients receiving dialysis. This study aimed to estimate serum level of IL31, in patients with uremic pruritus and to relate it with different clinical parameters. Methods: This was a prospective case-control study conducted on participants recruited from the hemodialysis unit of the Urology and Nephrology Center, Mansoura University. Results: serum IL-31 is significantly higher in patients receiving hemodialysis with pruritus symptoms, along with a positive exposure-response relationship between serum IL-31 and pruritus intensity. Conclusion: Uremic pruritus, a distressing symptom in end-stage renal disease patients on hemodialysis, lacks a definitive explanation, though factors like immune processes and IL-31 are considered. Its impact on patients' quality of life varies, making it challenging to characterize. Unraveling mechanisms like IL-31 may guide future treatments for this condition, which significantly affects patients' well-being.