Objectives: End-stage renal disease (ESRD) management relies heavily on patient’s adherence. Studies on the factors related to adherence have been done but are difficult to compare due to non-uniformity of the tools used. The ESRD - Adherence Questionnaire (ESRD-AQ) by Kim, et.al (2010) is a validated tool used to measure treatment adherence to the whole of ESRD management: hemodialysis, medications, fluid restrictions, and diet prescription. About 2000 ESRD patients have been registered in the Central Visayas, Philippines in 2022. The availability of a standardized and validated tool in the Visayan native language will help in assessing adherence and its related factors which can lead to interventions that could improve outcomes in ESRD patients. Methods: The ESRD-AQ underwent forward translation into a Visayan translation. This translation was evaluated for content validity using the Content Validity Index (CVI) and face validity. Blind backward translation was done and compared to the original ESRD-AQ. Construct validity was tested via a Known-Group Analysis. Test-retest reliability was done using the Intraclass Correlation Coefficient (ICC) to establish the questionnaire’s stability overtime. Results: The Visayan ESRD-AQ had adequate CVI of 1.0 meaning that each item on the questionnaire was relevant to its aim. Construct validity showed that the known adherers had higher scores than the known non-adherers and meant that the questionnaire was able to differentiate between the two groups. Intraclass Correlation Coefficient (ICC) showed scores of 0.52 and 0.69, meaning moderate reliability. Conclusions: The Visayan ESRD-AQ is a valid and reliable tool for measuring adherence behaviors in a sample of Visayan-speaking dialysis patients as supported by the results of the Content Validity Index, Known Group Analysis, and Test-Retest evaluaiton. The validated VESRD-AQ can be used for studying adherence behaviors of ESRD patients across the Visayan region of the Philippines and may be of help in policy making with regards to hemodialysis.