This study aimed to evaluate the psychological distress and self-esteem among patients undergoing hemodialysis. Chronic kidney disease (CKD) is a significant global health issue, affecting over 800 million people and causing substantial mortality. The study used a quantitative cross-sectional design with 30 dialysis patients from St. Joseph’s Hospital, Mysuru. Data were collected using standardized questionnaires, including the Kessler’s Psychological Distress Scale and Rosenberg’s Self-Esteem Scale. The results showed that 36.7% of the participants were doing well, 23.3% had mild psychological distress, 23.3% had moderate distress, and 16.7% had severe distress. Regarding self-esteem, 73.3% had normal self-esteem, 20% had low self-esteem, and 6.7% had above-average self-esteem. A significant relationship was found between social and family support and self-esteem (p=0.033). The study concluded that about half of the participants experienced mild to moderate psychological distress, while severe distress was seen in 16.7% of the samples. The majority (73%) had normal self-esteem, and 27% had mild to average self-esteem. The findings highlight the need for increased support and intervention to improve the psychological well-being of dialysis patients. Recommendations include replicating the study with a larger sample size in different populations.This study aimed to evaluate the psychological distress and self-esteem among patients undergoing hemodialysis. Chronic kidney disease (CKD) is a significant global health issue, affecting over 800 million people and causing substantial mortality. The study used a quantitative cross-sectional design with 30 dialysis patients from St. Joseph’s Hospital, Mysuru. Data were collected using standardized questionnaires, including the Kessler’s Psychological Distress Scale and Rosenberg’s Self-Esteem Scale. The results showed that 36.7% of the participants were doing well, 23.3% had mild psychological distress, 23.3% had moderate distress, and 16.7% had severe distress. Regarding self-esteem, 73.3% had normal self-esteem, 20% had low self-esteem, and 6.7% had above-average self-esteem. A significant relationship was found between social and family support and self-esteem (p=0.033). The study concluded that about half of the participants experienced mild to moderate psychological distress, while severe distress was seen in 16.7% of the samples. The majority (73%) had normal self-esteem, and 27% had mild to average self-esteem. The findings highlight the need for increased support and intervention to improve the psychological well-being of dialysis patients. Recommendations include replicating the study with a larger sample size in different populations.