Background/Aims: Little data are available about chronic kidney disease (CKD) and end-stage renal disease (ESRD) in Libya, therefore, we conducted a cross-sectional study to examine the epidemiological factors and frequency of diseases diagnosed in patients with ESRD who are receiving hemodialysis in the major three demographic areas of Libya. Patients and Methods: With a special focus on the three main demographic regions in Libya (East, West, South), in this study, we retrospectively examine and analyze data retrieved from patients who attended 31 hemodialysis centers in 2017. Patients' data were studied for baseline demographic information, gender, age, medical history, physical examination, laboratory results, and comorbidities. Results: More males than females were affected overall, with M:F ratio = 1.6. Approximately, two-thirds of patients resided in the western part of Libya, with a regional distribution of 68.41% in the West, 16.08% in the East, and 15.52% in the South. The majority of cases with ESRD (>60%) were either caused by hypertension (25.36%) or diabetes mellitus (23.75%), or a combination of both (12.93%). On the other hand, genetic diseases caused 8.18% of the cases, whereas glomerular diseases caused 5.98%. Conclusion: The public health legislators and Ministry of Health should focus on tackling the modifiable risk factors of hypertension and diabetes early at a population level to reduce the burden of CKD and the development of ESRD. Early detection of genetic causes is an important health measure through the implementation of screening in high-risk groups and appropriate genetic counseling.