Background: Infection comes after cardiovascular disease with fatal outcome in patients with End-Stage Renal Disease ESRD and no standardized conventional biomarker for diagnosis of bacterial infection. Presepsin is a fraction of soluble subtypes of CD14 (sCD14- ST) and can be used as a biomarker for acute bacterial infections. Aim of the work: evaluation of presepsin as a possible biomarker of acute bacterial infections in chronic hemodialysis (HD) patients in Egypt and comparing it with other inflammatory markers, such as C-reactive protein (CRP), ferritin and albumin. Patients and methods: This study included 60 chronic HD patients that were divided into 2 groups: 30 HD patients with infection (infection group), 30 HD patients without infection as control (non -infection group). Total leucocytic count (TLC), Erythrocyte Sedimentation Rate (ESR), (CRP), ferritin, albumin and presepsin levels were measured in the patients groups. Results: presepsin levels were significantly higher in the infection group than in the non-infection group. presepsin levels were significantly and positively correlated with serum ferritin and CRP. At a cut off value of 970 ng/L; the sensitivity of presepsin was 73.3% and the specificity was 81.2%.Conclusions: presepsin was better than TLC and ESR, it was not inferior to CRP and ferritin and it was not superior to albumin for the diagnosis of acute bacterial infections in HD patients. Presepsin could be used as a biomarker for the diagnosis of acute bacterial infections in HD patients with moderate sensitivity and specificity at a cut off value of 970 ng/L .