Background. Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis (HD), which prolongs life expectancy, giving time for these changes to manifest. Objective. To estimate the prevalence and pattern of cutaneous manifestations among Delta patients with chronic renal failure on regular HD and correlates their onset to HD. Patients and methods. One hundred patients with CRF on regular HD selected and subjected to full history taking, general and dermatological examination of skin, hair, nails and oral mucosa. Results. All patients included in this study had at least one cutaneous manifestation attributed to CRF. The most prevalent skin findings were xerosis (72%), followed by pruritus (52%) and hyperpigmentation (44%); while purpura (2%) and bullous dermatosis (1%) were the least detected. Oral mucosal manifestations included xerostomia (46%), macroglossia with teeth markings (43%), fissured tongue (17%), ulcerative stomatitis (11%) and angular cheilitis (6%). The commonest nail manifestations were absent lunula (61%), half and half nail (41%), and koilonychia (29%). Hair manifestations included sparse scalp hair (48%), sparse body hair (41%), and brittle and lusterless hair (39%). Hypertension and diabetes mellitus were the commonest causes of CRF (53% and 18% respectively). Conclusion. Every CRF patient on HD had at least one cutaneous manifestation, which may appear before or after hemodialysis. The most common cutaneous manifestations were xerosis, pruritus, hyperpigmentation, xerostomia, macroglossia, absent lunula, half and half nail , sparse scalp hair and sparse body hair. Hypertension and diabetes mellitus were the commonest causes of CRF (53% and 18% respectively).