Background: Muscle cramps are a common intradialytic complication among elderly hemodialysis patients, which can be prevented through the application of intradialytic stretching exercises. Purpose: Determine the effect of intradialytic stretching exercises on muscle cramps among elderly patients on maintenance hemodialysis. Design: A quasi-experimental research design (one group pretest/ posttest design) was utilized. Setting: The study was conducted at hemodialysis unit in Meet Khaqan Health Center affiliated to Shebin El-Kom Fever Hospital. Methodology: Sample: The study subjects comprised of a purposive sample of 50 elderly patients who were registered in dialysis unit's files with end stage renal disease. Instruments: 1) Structured interviewing questionnaire. 2) cramp questionnaire chart and visual analogue scale to assess patients' level of muscle cramps. Results: The mean age of the studied patients was 65.06 ± 4.96 years old, 60% of them were males and 88% had associated chronic diseases. There was a highly statistically significant difference in the level of muscle cramps pre and post implementation of intradialytic stretching exercises (p < 0.001**). Conclusions: After application of the intradialytic stretching exercise, a significant reduction in the level of muscle cramps had been observed. Therefore, intradialytic stretching exercises are an effective, simple, and safe procedure that could prevent or reduce the level of muscle cramps among elderly patients undergoing hemodialysis. Recommendation: The current study can be replicated for elderly HD patients with a larger sample size from different geographical areas for better generalization.