Abstract: Background: Tele-nursing is considered one of the most important technological events of the late century as the gateway to the modern nursing care to improve patients' knowledge and adherence to therapeutic regimen. Purpose of the study was to examine the effect of tele-nursing education intervention on knowledge and adherence to therapeutic regimen of hemodialysis patients. Design: A quasi- experimental (study and control group) with pre and post research design was used. Setting: This study was conducted at kidney dialysis unit at AL Shuhada Central Hospital and kidney dialysis unit affiliated with the Association for the Preservation of the Holy Quran at Al Shuhada district, Menoufia Governorate, Egypt. Sample: A purposive sample of 100 hemodialysis patients who was assigned randomly into two equal groups (study group and control group 50 subjects for each one). Instruments for data collection: - A structured interviewing questionnaire including socio-demographic characteristics as well as patients' knowledge about kidney and chronic kidney diseases questionnaire and adherence to therapeutic regimen questionnaire. Results:- There was a significant improvement in mean scores and levels of knowledge and adherence to therapeutic regimen at post-test1 and post-test 2 than pre-test of tele-nursing education intervention among the study group compared to the control group. Conclusion: Tele-nursing education intervention was an effective method to improve hemodialysis patients' knowledge and adherence to therapeutic regimen among the study group compared to the control group. Recommendation: Empowering nurse practitioners with tele-nursing knowledge and hands-on skills through training programs.