Objectives: End-stage kidney disease (ESKD) is a rapidly increasing global health burden. The prevalence of psychological issues among individuals with ESKD has increased, potentially impacting clinical outcomes. This study aimed to determine the prevalence and associated factors of depression and anxiety among hemodialysis patients in Thailand Methods: The study population consisted of 766 dialysis patients from eight facilities across Thailand. The assessment tools used were the Hospital Anxiety and Depression Scale (HAD) and the SF-36, Thai edition. Results: The findings revealed a high prevalence of these conditions, with rates for anxiety and depression standing at 24.8% and 28.5%, respectively. These rates were significantly higher than those observed in the general population. The study also found that increasing age was associated with increasing anxiety and depression scale (P=0.005), and that the unemployed group had the highest scale compared to other occupational groups (P=0.029). However, anxiety or depression were not found to be associated with the level of hemoglobin or dialysis adequacy, On the other hand, SF-36 health-status scale was strongly correlated with hemoglobin levels (P=0.041). Conclusions: In summary, this study provides valuable insights into the prevalence rates of psychological issues among hemodialysis patients in Thailand. These findings can inform healthcare practitioners and policymakers in the development of interventions to improve mental well-being of hemodialysis patients in Thailand.