Background: With the rising trend of diabetes mellitus and hypertension in developing countries like India, there is also a rise in chronic complications like end stage renal disease (ESRD). ESRD poses a huge financial burden on family and health care sector due to a high morbidity and mortality associated with it. Cardiovascular complications remain the most common cause of death among ESRD patients and those undergoing hemodialysis (HD). Hemodialysis patients behave in a distinct way that they are relatively more prone for bleeding than thrombotic manifestations. In recent days abnormalities in platelet parameters are found to be an effective tool in risk stratification of patients with chronic kidney disease (CKD) to develop coronary artery disease. Due to scarcity of literature especially from India, the present study was taken to find the association of various platelet parameters among hemodialysis patients. The aim was to study the platelet distribution width (PDW), mean platelet volume, platelet count, plateletcrit and platelet large cell ratio (PLCR) among ESRD patients undergoing maintenance hemodialysis and compare with healthy age and sex matched controls. Methods: The present study was done on two groups. Group A (Cases) consisting of 40 ESRD patients receiving HD for more than 6 months, and group B (controls) consisting of 40 healthy controls from hospital staffs and healthy volunteers matched for age and sex. Results: The mean values of platelet distribution width (PDW), mean platelet volume, platelet count, plateletcrit and platelet large cell ratio (PLCR) were found to be lower in cases when compared to healthy controls. PDW, platelet count and plateletcrit attained statistical significance, while others did not. Conclusions: Abnormality in platelet parameter to assess CVD risk may be applicable in general population as well as in CKD patients, but its role in hemodialysis patient’s further need to be evaluated.