Abstract: The aim of this study is to document the prevalence of HTN and characterize risk factors associated with HTN in Iranian hemodialysis patients. Three hundred and thirty seven HD patients from 5 university based HD centers around Iran were enrolled in the study. Urea reduction ratio was calculated using formula: 100 * (1-(urea before HD/urea after HD)). Pearson Chi-square test, independent sample t-test and one way ANOVA were used for evaluations, where appropriate. Multivariate logistic regression model was used for defining independent risk factors. Two sided p<0.05 were considered significant. Patients with diabetes mellitus and hypertension as causes of ESRD significantly were more likely to have hypertension before and after dialysis (p<0.05). Patients with conventional thrice weekly dialysis (compared to twice), hemodialysis duration of more that 6 months, acetate type of dialysate, ESRD cause when diabetes mellitus and hypertension, were significantly associated with having pre-HD hypertension. We also found that hemodialysis center of the capital city had a significant better measures compared to other cities (p<0.05). This study revealed a relatively acceptable prevalence of hypertension in our HD population. Nevertheless, because of higher prevalence of HTN in HD centers out of capital city, it seems necessary that we should urgently pay more attention in promotion of these centers toward achieving better outcome with implementing strict guidelines to follow