Objectives: This study aimed to determine and assess the prevalence of depression, anxiety, and stress of the COVID-19 pandemic among outpatient hemodialysis patients and the relationship to sociodemographic and clinical factors, and to assess the economic impact of the COVID-19 pandemic. Methods:  In this analytical, cross-sectional study, purposive sampling was used and a total of 69 subjects were enrolled. Sociodemographic data were collected using researcher-administered questionnaires and recent laboratory parameters were collected by reviewing medical records. Patients completed 4 sets of questionnaires including Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), Perceived Stress Scale 4 (PSS-4), and CoRonavIruS Health Impact Survey (CRISIS).  Quantitative variables were presented using mean and standard deviation, median, and Interquartile Range (IQR). Qualitative variables were presented using frequency and percentages. Pearson’s correlation was used to determine the relationship of laboratory parameters with anxiety, depression, and stress scores. The Chi-Square test was used to determine the relationship of sociodemographic profile with anxiety, depression, and stress scores. P values <0.05 were considered statistically significant. Results: Our study showed that the prevalence of anxiety, depression, and stress were 39%, 16%, and 51% respectively. There was an association between age and stress level, with older subjects reporting higher stress scores. Hemoglobin levels had a weak negative correlation with anxiety, depression, and stress. The distribution of anxiety scores was significantly different between patients with normal phosphorus levels and elevated phosphorus levels. Financial worries were less of a concern since almost two-thirds of our subjects were retired and unemployed. Conclusions: Hemodialysis patients belong in high-risk populations with a high prevalence of psychological distress hence they are subjected to more severe psychological stress, depression, and anxiety. Our findings suggest that psychological intervention may be necessary for some patients during this pandemic.