End-stage renal disease (ESRD) has become a worldwide health concern. No clear information is available about the causes of ESRD in ALQALUOBIA Governorate, Egypt. Awareness of the cause of ESRD will help in not only delayed the onset of haemodialysis; but may the management of some causes to prevent ESRD. This is a cross-sectional study designed to determine the etiology of ESRD under maintenance haemodialysis patients in Benha, Alqaluobia Governorate, Egypt; and was conducted between August 2015 and June 2017 on 500 patients. We founded that hypertension and diabetes mellitus are the most common causes in different age groups and unknown causes were 24% of all causes of ESRD; increased to 53.3% in patient group less than 40 years old.