Background: End-stage renal disease (ESRD) is a serious irreversible progressive disease with high prevalence worldwide, that makes life un sustainable in the absence of renal replacement therapy, hemodialysis (HD) is the most widely used therapy. Objective: To determine the effect of intradialytic exercise on physiological parameters, biochemical markers, and quality of life among patients on hemodialysis. Design: a quasi-experimental research design. Setting: The study was conducted at the hemodialysis units of the National Medical Institute in Damanhur, Elbeheira governorate. Subjects: A convenience sample of 50 patients. Tools: two tools were used for data collection. The first tool was Socio-demographic and Clinical Data Structured Interview Schedule. The second tool was the Kidney Diseases Quality of Life Short Form (KDQoL-SFTM 1.3). Results: Intradialytic exercise program has a positive effect in reduction of serum urea and creatinine and improving levels of some electrolytes as serum phosphate, potassium, calcium, haemoglobin level, Systolic and diastolic blood pressure. In addition, there was a significant statistical difference between the study and control groups in most domains of QOL (P < 0.05) except work status and staff encouragement. Conclusion: The study concluded that hemodialysis patients who practice intradialytic exercise exhibit significant improvement in biochemical markers, blood pressure and quality of life than those who don`t practices it. Recommendations: Application of educational program should be carried out for hemodialysis patients at hemodialysis unit to be aware about the importance of intradialytic exercises which help them to improve their quality of life.