Hepcidin, a key regulator of iron homeostasis, plays a pivotal role in the pathogenesis of anemia in patients with end-stage renal disease (ESRD). ESRD patients on regular hemodialysis often experience disturbances in iron metabolism, contributing to treatment-resistant anemia. This study aims to evaluate serum hepcidin levels in ESRD patients undergoing regular hemodialysis and explore its clinical implications. To estimate and analyze serum hepcidin levels in ESRD patients on regular hemodialysis and to correlate these levels with anemia severity, iron parameters, and markers of inflammation. This cross-sectional study included hundred ESRD patients undergoing regular hemodialysis at Abass Ibrahim Dialysis Center, Kosty, Sudan. Serum hepcidin levels with relevant hematological parameters, including hemoglobin, serum ferritin, transferrin saturation, and C-reactive protein (CRP), were measured. Statistical analyses were performed to assess correlations between hepcidin levels and clinical variables. The study revealed significantly elevated serum hepcidin levels in ESRD patients compared to healthy controls (19.4±6.2, and 9.8±6.5, respectively). Hepcidin levels showed a positive correlation with serum ferritin (362.7±21.5, p<0.05) and CRP (16.8±19.9, p<0.05) while demonstrating a negative correlation with hemoglobin (8.7±1.8, p<0.05). These findings highlight the interplay between iron dysregulation, inflammation, and anemia in ESRD patients. Elevated hepcidin levels in ESRD patients undergoing regular hemodialysis are associated with anemia severity and inflammatory status. Targeting hepcidin dysregulation may offer novel therapeutic opportunities to manage anemia in this patient population.