Background: Minimizing volume overload by optimizing the target dry weight (DW) in hemodialysis (HD) patients depending on clinical evaluation lack accuracy as signs of hypervolemia are observed only when over hydration is significant. Objective: To evaluate the diagnostic accuracy of serum level of brain natriuretic peptide (BNP) and it’s correlation with lung ultrasound (LUS) in detecting the presence of asymptomatic pulmonary congestion as a sign of residual volume overload in HD patient. Patients and Methods: A Prospective observational study was conducted on 20 HD patients with asymptomatic pulmonary manifestation who underwent LUS and BNP leveling before and after HD session, LUS was considered a positive when B-line score (BLS) >10. Volume load parameters were also evaluated before and after HD. Results: the reduction in mean BNP after HD session was significant as BNP levels reduced from (219.5±67.802) pg/ml to (116.75±50.772) pg/ml, with significant positive correlation between post dialysis BNP and BLS (p< 0.001, r 0.914). Conclusion: A number of patients who were clinically euvolemic with no clinical parameters of overhydration at the end of HD session and believed at target DW demonstrated lung congestion at LUS. This suggest that patients at their supposed target DW may still have a residual volume overload that can be intercepted by LUS assessment and when LUS is not available, BNP leveling may be of some help.