To set the scene, moderate to severe lung congestion was present in roughly 60% of ESRD patients prior to hemodialysis [HD], and this change is often asymptomatic. One-third to one-fourth of patients still have excessive lung water following dialysis, despite the fact that congestion in the lungs is decreased. Our research aimed to determine how useful lung ultrasonography is for identifying pulmonary congestion in hemodialysis patients. Methods: One hundred hemodialysis patients were enrolled in a prospective clinical research from August 2020 through August 2021 at the Critical care department at Benha university hospital. Conclusion: Our findings show that the B-lines and IVC width of the research patients significantly alter between before and after dialysis. It was concluded from this study that Chest US is a well validated simple and low-cost technique that can be easily applied at the bedside to assess of volume status before and after a dialysis session and to detect pulmonary congestion at a pre-clinical stage that is associated with a high death risk. In addition to chest ultrasonography, monitoring IVC diameter before and after dialysis may be utilised to evaluate volume status in patients with ESRD.