Background: Hemodialysis patients are prone to frequent infections, especially of the vascular access site, and often harbor antimicrobial-resistant pathogens. Implementation of a surveillance system to monitor and prevent infections in these patients is therefore of extreme importance.Methods: A cross sectional study that was carried out on 28 ESRD patients on regular hemodialysis with infected accesses from a total number of 198 hemodialysis patients over 4 months period (from January 2013 to April 2013) in both (Nephrology & dialysis unit and King Fahd dialysis unit) at Kasr Elainy Teaching Hospitals. Data analysis was performed and tabulated with the use of descriptive statestics to assess the overall incidence of infection related to hemodialysis vascular access.Results: the incidence of infection in non tunneled hemodialysis catheters was 44%, in tunneled catheters 33% and in grafts was 17%. The incidence of infection in AV Fistulae was 9%. The infected internal jagular catheters were (39%) while the infected subclavian catheters were (36%). All the infected non tunneled catheters 8 patients (100%) and 2 patients (50%) of the 4 infected tunneled catheters were exit site infection. The other 2 infected tunneled catheters include 1 patient with cellulities along the tunnel and 1 patient with abscess. The infected grafts were 3 of which 2 grafts (66.6%) with cellulitis and 1 graft (33.3%) with abscess. The infected AV Fistulae were 13 of which 9 patients (69.2%) with cellulitis, 3 patients (23.1%) with abscesses and 1 patient (7.7%) with secondary hemorrhage. Conclusion: Event rates were highest among patients with temporary catheter. Local factors in our region have often resulted in delays in the creation of vascular grafts for hemodialysis access and these delays have, in turn, increased our dependence on central venous hemodialysis catheters as an alternative access. These results can be used for quality improvement and to help evaluate the efficacy of specific infection control measures.