Adherence to dietary guidelines, fluid restriction, prescription medicines, and hemodialysis (HD) sessions is essential for optimal and successful therapy. Nonadherence is linked to a variety of unfavorable clinical outcomes and decreases the quality of life of patients. The study aimed to assess the adherence of hemodialysis patients toward their therapeutic regimen. A descriptive study (cross-sectional) was started from the 19th of September, 2021, to the 6th of July, 2022. The study was carried out in two artificial kidney centers at Al-Hilla teaching hospitals. The non-probability purposive sample consisted of 100 patients with ESRD who received hemodialysis treatment. The data was collected by using a modified questionnaire used to assess the adherence of hemodialysis patients toward their therapeutic regimen. Then this data was electronically analyzed using SPSS Version 26. The results revealed that the greatest percent of the study sample (36%) were aged 60 years and older, more than half (58%) were males, and the majority of the sample (74%) were married. 40% had only hypertension as a chronic disease. 72% of them received two hemodialysis sessions per week, and 46% had a hemodialysis duration of 6–12 months. The overall findings of hemodialysis patients' adherence demonstrated that 90% of them expressed a moderate level of adherence to the therapeutic regimen. The study concluded that the adherence of hemodialysis patients toward their therapeutic regimen was moderate.