Objectives: Patient Reported Outcome Measures (PROMs) which include post-dialysis fatigue is an important predictor among end-stage kidney disease (ESKD) patients that adversely affects their quality of life. Dialysis recovery time (DRT) is a reliable indicator of post-dialysis fatigue. This study aims to determine factors influencing DRT among in-center maintenance hemodialysis (HD) patients. Methods: A cross-sectional study was conducted among prevalent ESKD patients aged >18 years, >3 months on HD in three different centers. Demographic data, comorbidities, dialysis parameters and laboratory investigations were recorded. All patients were asked regarding DRT and interviewed using a validated Integrated Palliative Outcome Symptom (iPOS) renal questionnaire. They were divided into three groups: Group 1: DRT <2 hours, Group 2: DRT between 2 to 4 hours, and Group 3: DRT >4 hours. Results: A total of 123 patients were included in the study, with mean age of 57.62 ± 14.25 years. Seventy (56.9%) patients were male, and 53 (43.1%) were diabetics. Multivariate analysis revealed that mean hemoglobin levels were significantly lower in patients with DRT >4hrs at 9.72 ±1.53 g/L vs 11.00 ±1.93 g/L in group 1, and 10.58 ±1.66 g/L in group2, p= 0.07. Patients with DRT >4 hours also had lower serum magnesium levels and longer dialysis vintage compared to patients in groups 1 and 2, p<0.05. Results are shown in Table 1. There was no significant association between DRT and age, gender, race, diabetes, body mass index, employment status, dialysate sodium, ultrafiltration rate or serum albumin. Conclusions: Anemia, lower magnesium levels and longer dialysis vintage significantly affected DRT. Patients with DRT >4 hours were also found to have much higher iPOS scores, translating to increased symptom burden. Practical, cost-effective measures in correcting anemia and maintaining high normal magnesium levels could potentially improve patient reported outcome in hemodialysis patients with post-dialysis fatigue.