Abstract Background and Aims Pruritus associated with chronic kidney disease (CKD-aP) is a common condition. However, although pruritus seriously affects the physical and mental health of patients, clinicians tend to underestimate this condition. The aim of this study is to determine the prevalence of Pa-MRC and its impact on the quality of life (QOL) in the Tunisian hemodialysis population. Method This is a prospective observational study conducted at the hemodialysis unit at Taher Sfar University Hospital (February - May 2022). The presence and severity of Pa-MRC were documented based on a 5-D pruritus questionnaire, demographic and clinico-biological data were extracted from the dialysis unit register. Results A total of 63 chronic hemodialysis patients (CHD) were recruited in this study, 68.3% of whom presented pruritus, most often generalized (2/3 cases). More than half of the patients reported pruritus throughout the day. Thirty patients reported moderate to severe Pa-CKD. Patients were not treated for pruritus in 72% of cases, but 92% of those treated were satisfied with their treatment. Patients reporting a more severe Pa-CKD had a shorter duration of dialysis, higher phosphate and parathormone levels and more frequent diabetes (p = 0.03). The QOL deteriorated when the severity of pruritus increased (p = 0.01). Patients reported having difficulty falling asleep (52%), irritability (61.4%), concentration disorders (31.8%). In addition, pruritus limits the daily life of patients in 59.1% of cases with an impact on nutritional status in 13.6%. Conclusion This study reveals that Pa-CKD is a distressing condition with a huge impact on the QOL of CHD patients. However, there is an unmet need for treatment, hence the need for new therapeutic approaches.