End-stage renal disease is emerging as a major public health problem in the developing countries. It must be treated with renal replacement therapy and hemodialysis (HD) is the most widely used therapy and the only maintenance treatment if kidney transplant is not feasible. This study aimed to determine the effectiveness of intradialytic exercise on dialysis efficacy, physiological parameters, biochemical markers, and quality of life among patients on HD. Experimental research design was adopted to conduct the study with 20 patients in our HD unit who met the inclusion criteria and patients were randomly allocated into experimental group and control group. The experimental group received intradialytic exercise during the first 2 h of HD besides receiving routine care compared to the control group. Data were tabulated and analyzed using the SPSS package. The finding of the present pilot study reveals that the prescribed intradialytic exercise intervention resulted in significant improvement in Kt/V, serum creatinine, blood urea, serum potassium, phosphorous, and quality of life. Based on the findings of the present study, it can be concluded that intradialytic exercise program is a safe complementary intervention and does not need an extra time of the patient and showed improvement in patients' outcome.