Background: To prevent and treat mineral bone damage in those with long-term kidney failure [CKD-MBD], early detection and intervention are crucial. Osteocytes, odontoblasts, and osteoblasts create a protein called osteocalcin [OC], which is dependent on vitamins K and D. It is present in serum and deposited in the extracellular bone matrix. Serum osteoblast activity and bone formation rate are thought to be indicated by serum OC hydrolyzed in the kidney and liver. It might impact mineralization, bone turnover, and osteoblast function control. Aim and Objectives: to assess the serum osteocalcin levels in Egyptian patients receiving regular hemodialysis as a biomarker of osteoporosis due to chronic renal failure.  Patients and methods: The Beni-Suef University Hospital's internal medicine department and hemodialysis unit were the sites of this case-control research. In addition to 45 healthy controls, 45 CRF patients were included in this research.  Results: When comparing Dexa results, kidney function tests, osteocalcin levels, correlations between osteocalcin levels, and other laboratory investigations, the study found a statistically significant difference in the sensitivity and specificity of osteocalcin levels in the diagnosis of osteoporosis CRF cases from controls. Specifically, there was a significantly lower GFR [mean 7.09] and a significantly higher level of osteocalcin [mean 62.1] with a p-value <0.05 among cases compared to controls [mean 29.6]. These findings concluded that osteocalcin levels were elevated in CRF patients with osteoporosis. Conclusion: Osteocalcin may be a useful biomarker for osteoporosis early detection ing patients receiving frequent hemodialysis and chronic renal failure. According to the study, serum osteocalcin measurement may be utilized as a potential supplementary biomarker in conjunction with a Dexa scan for the early identification of CKD-MBD and the tracking of osteoporosis progression in clinical settings.