Objective: The aims of this study were to assess anxiety and depression risk in hemodialysis patients with end-stage renal failure, and to compare illness perception between patients with or without anxiety and depression risk, using Leventhals model. Methods: This cross-sectional study was conducted on 124 patients of three major university hospitals. Subjects were 18 years or older, undergoing treatment in a hemodialysis unit for at least 6 months, literate and could communicate in the Turkish language. Patients who were mentally retarded or had psychiatric conditions i.e. psychotic disorders were excluded from the study. Voluntary informed consent was sought from all subjects. Data were collected with a semi-structured questionnaire, Hospital Anxiety and Depression Scale and Illness Perception Questionnaire-Revised (IPQ-R). Illness perception was grounded on Leventhals self-regulation model. Data were analyzed using frequency distributions, Students t-test, ANOVA, Pearson correlation and chi-square tests. Results: The mean age of patients was 50.7±14.5 (18-80) years, 55.6% were male, 33.9% were literate and most (69.4%) were married. Our results showed that 22.6% of the subjects who underwent hemodialysis for an average of seven years were at risk for anxiety and 49.2% for depression. Patients with anxiety risk had lower IPQ-R dimensional scores (t=4.08, p [Anadolu Psikiyatri Derg 2013; 14(3.000): 252-259]