Oxidative stress has been shown in either hemodialysis patients or smokers in relation with an increased production of free radicals. We want to assess the effects of smoking on oxidative stress markers; malondialdehyde (MDA), protein carbonyl content and total sulfhydryl groups, in chronic hemodialysis (HD) patients. Ten smoker HD patients (6 men and 4 women, ages 44 ± 14 years), ten non-smoker HD patients (6 men and 4 women, ages 55 ± II years) and ten non-smoker healty subjects as a control were recruited. The results showed that serum MDA and protein carbonyl levels were found to be significantly increased either in smoker HD patients (p<0.05, p<0.05 ) or in non-smoker HD patients (p<0.05, p<0,05). Also there was a significant difference in serum MDA and carbonyl content levels between smoker and non-smoker HD patients (p<0.05). Serum total sulfhydryl groups in smoker and non-smoker patients were significantly lower than those in controls. (p<0.05, p<0,05). Conclusion; We demonstrate smoking may aggrevate oxidative stress in hemodialysis patient.