Background: Hemodialysis is critical process for chronic renal failure patient that make them have several health needs that must be met to improve the patient self-efficacy. Aim of the Study: This study aimed to assess health needs and identify self-efficacy for patients undergoing hemodialysis. Subjects and method: Design: A descriptive design was used in carrying on this study. Setting: The present study was conducted at the hemodialysis units of El-Salam and Al-Hayah Hospitals that affiliated to the universal health insurance in Port Said Governorate. Subjects: Subjects were recruited using a purposive sampling technique. The total number of patients was (100) patients. Tools: Three tools were used. First tool is demographic characteristics and Patient's health history sheet. Second tool was health needs assessment scale. Third tool was Self –Efficacy for Managing Chronic Disease Results: The results revealed that all studied patients have met level of arteriovenous access care, 98% of studied sample have met level of psychological need, while 96% , 95% & 88% of them have unmet level of diet , sleep &hygiene and mobility needs respectively. There was significant negative correlation between total health needs scores and total self- efficacy scores among studied sample. Conclusion There was significant negative relation between total health needs and total self-efficacy. Recommendations: Provide Patients undergoing hemodialysis with needed pamphlets, posters and booklets including instructions that contain information about hemodialysis therapy, diet schedule, medication, life style changes.