Background Maintenance hemodialysis(MHD) patients often suffer from fatigue and are recommended to undertake physical activities. The optimal format of exercise rehabilitation for MHD patients remains uncertain despite demonstrated health benefits. This study aimed to evaluate the effectiveness of an intradialytic group exercise programme for MHD patients. Methods This was a single-centre, single-group repeated-measures design study. The 12-week, three times per-week intradialytic group exercise programme was conducted for around 30 min during the first 2 hours of each dialysis session. Patient-reported outcomes including fatigue, anxiety, depression and health-related quality of life, laboratory parameters including haemoglobin, albumin, pre-albumin and hypersensitive C-reactive protein, and anthropometric parameters including triceps skinfold thickness, mid-upper arm circumference, mid-arm muscle circumference and handgrip strength, were measured at baseline, immediately post-intervention and 12-weeks post-intervention. The repeated-measures analysis of variance and Friedman test were used to compare the parametric and non‐parametric data across time points, respectively. Results Ninety patients were enrolled and 75 completed. Participants reported significant improvements across time points in fatigue ( F = 10.19, p < 0.01), depression ( F = 19.20, p < 0.001), health-related quality of life ( F = 5.36, p = 0.006), haemoglobin ( F = 3.43, p = 0.047), albumin ( F = 4.42, p = 0.032), hypersensitive C-reactive protein ( χ 2 = 50.39, p < 0.001), pre-albumin ( χ 2 = 11.85, p = 0.003), triceps skinfold thickness ( F = 25.03, p < 0.001), mid-upper arm circumference ( F = 6.32, p = 0.005), mid-arm muscle circumference ( F = 4.89, p = 0.02), and handgrip strength ( F = 13.59, p < 0.001). Although the mean anxiety score tended to reduce, the difference across time points was nonsignificant ( F = 1.33, p = 0.27). Conclusion The findings suggested that the intradialytic group exercise programme could improve MHD patients’ fatigue, depression, health-related quality of life, nutritional status, and inflammation. Trial Registration Chinese Clinical Trial Registry ChiCTR2000034394 (04/07/2020).