Background: Uremic pruritus (UP) is commonly described as a daily or near-daily occurrence of itch that spans large bilaterally symmetrical surface areas. Blood lead level (BLL) has been noted to be associated with inflammation and nutritional status in long-term HD patients. Objective: To evaluate the possible relationship between BLL and UP in chronic HD patients. Patients and Methods: This Cross-Sectional Study was carried out in the Hemodialysis Unit in EL Agouza Hospital from November 2018 to the end of April 2019 and included 100 randomly selected patients with end- stage who received hemodialysis sessions thrice weekly, four hours /session, for more than 6 months. Dialysate with standard ionic composition and a bicarbonate-based buffer is used for all patients. Results: The mean age of the chosen patients were ±SD 48.6 ± 7.1 years and the difference among the groups was non-significant (p-value 0.116). The study included 42 females (42%) and 58 males (58%). There was no significant difference among the studied groups (p=0.292) regarding sex. According to Pruritus Onset in our study, there was a non-statistically significant difference among the studied groups. In our study, there was a statistically highly significant difference among different groups regarding Serum Lead (μg/dL) (p-value <0.001). In our study, Serum Lead ≥ 14μg/dL is a cut-off value predictor for pruritus in HD patients with a sensitivity of 89.5%, specificity of 64.2%, and an accuracy of 69%. Conclusion: Serum Lead is a predictor for the incidence of pruritus in patients with end-stage renal disease maintained on hemodialysis.