OBJECTIVES: To examine the demographic, clinical characteristics and independent risk cause of sudden cardiac death in HD patients.   METHODS: We analyzed the data of 410 hemodialysis patients, who were undergoing hemodialysis in a tertiary care teaching hospital and were followed for a median of 3 years. Baseline demographic data, comorbidities, biochemical parameters, ECG, and ECHO all these data was assessed form the patient files. The logistic regression was applied to obtain the adjusted odds ratio and 95% CI were calculated. In all tests, a probability of p < 0.05 was considered as statistically significant. RESULTS: During follow-up, SCD was observed in 65 HD patients and non-sudden death in 165. The patients included in the study were with the mean age of 57 ± 14 of which 66.5% were male and 60.8% of the patients suffered from diabetes being a major cause for ESRD. Patients with age > 45, higher prevalence of diabetes, IDH, troponin T and other infection showed P value of 0.013, 0.002, 0.02, 0.05, 0.016 respectively, therefore predisposing these patient population at higher risk for SCD. Use of central venous catheter was associated with a 26.9 fold increase risk of death within first 90 days of initiation of HD. CONCLUSIONS: Our study showed,  type of vascular access for HD procedure, age, IHD, diabetes, LVH, LVSD, and EF are important factors for the survival of these patients and off the other factors found significantly associated to SCD were heart rate, breathlessness, other infections, catheter use, sodium levels and cholesterol levels.