Objectives: We reported that exercise was an important determinant of muscle strength, and that steady exercise improved leg muscle strength (LMS) after a year of observation in hemodialysis (HD) patients. In this study, we evaluated the impact of home- and hospital-based exercise on muscle strength in HD patients. Methods: We interviewed home-based exercise status and considered the participation in the hospital-based intradialytic resistance exercise four times from January (Jan) 2020 to Jan 2022. We measured hand grip strength (HGS) and LMS (n=104) by using digital dynamometer.  Results: 81.7% and 36.5% of patients answered ‘yes’ to regular home-based and intradialytic resistance exercise at least once during the study period, respectively. Patients who answered ‘yes’ to the home-based exercise 2 times or more (more home exercise group) showed marginally higher LMS (29.1 vs. 25.1 kg, p = 0.079). Patients in the more home exercise group showed longer HD vintage (39 vs. 70 months, p = 0.003), higher Kt/V (1.39 vs. 1.48, p = 0.009), higher albumin (3.65 vs. 3.86 g/dl, p = 0.008), higher serum calcium (8.8vs. 9.1 mg/dl, p = 0.044), and lower highly sensitive C-reactive protein (0.88 vs. 0.26 mg/dl, p = 0.016), respectively. Multiple linear regression analysis showed that more home-based exercise was associated with marginally better HGS (standardized coefficient 0.14, p = 0.08) and significantly better LMS (standardized coefficient 0.27, p = 0.004). However, these effects were offset after the further adjustment by baseline HGS and LMS in Jan 2020.  Conclusions: Usual home- or hospital-based exercise did not affect muscle strength in HD patients. Baseline muscle strength was the most important and determined whether HD patients exercise or not. What matters are preventing the occurrence of sarcopenia, and maintaining physical activity and exercise above a certain level at home or at the hospital.