Introduction: End-stage renal disease (ESRD) is the last stage of chronic kidney disease (CKD) and those patients are at a higher risk of major adverse cardiovascular and cerebrovascular events. Renalase is a novel protein with monoamine oxidase activity and is secreted by the kidney playing a major role in the regulation of blood pressure. Recent studies have suggested serum renalase levels to be related to adverse renal outcomes in patients with chronic kidney disease. Aim: To estimate the levels of serum renalase in ESRD patients on Maintenance Hemodialysis (MHD) and to compare the levels with healthy controls and assess the relationship of serum renalase with other analysed parameters in ESRD patients. Materials and Methods: 60 ESRD patients on MHD and 50 healthy individuals were analysed for serum renalase, fasting blood glucose, urea, creatinine, lipid profile, albumin and haemoglobin levels. Results: The mean level of serum renalase in hemodialysis patients was 68.69__ampersandsignplusmn;34.52ng/ml which was significantly higher than the controls (45.70__ampersandsignplusmn;22.18ng/ml)(p-value__ampersandsignlt;0.01). Serum renalase had a significant positive correlation with fasting blood glucose, urea, creatinine, triacylglycerol, dialysis duration and age (r=0.55, r=0.51, r=0.32, r=0.30, r=0.38 and r=0.41 respectively, p value__ampersandsignlt;0.05) and was negatively correlated with weight, albumin, haemoglobin and eGFR (r-value = -0.33, -0.35, -0.24 and -0.33 respectively, p-value__ampersandsignlt;0.05). Conclusion: Serum renalase is significantly elevated in ESRD patients on maintenance hemodialysis. Serum renalase levels had an association with age, weight, fasting blood glucose, urea, creatinine, eGFR, dialysis duration, triacylglycerol, albumin, and haemoglobin.