Background: Red cell distribution width (RDW) is very important for the clinical diagnosis and progression of end-stage renal disease (ESRD). However, the relationship between RDW and associated factors among ESRD was not well explored. The aim of this study was, therefore, to investigate RDW and associated factors among ESRD patients in governmental hospitals in Addis Ababa, Ethiopia.rnMethods: A cross-sectional study design was conducted on a total of 83 patients who had follow-up before undertaking the procedure of hemodialysis. RDW, mean corpuscular volume, serum creatinine, blood urea nitrogen, glomerular filtration rate (GFR), fasting blood sugar, and serum albumin were determined from end stage renal disease patients. Blood pressure (mmHg), body weight (kg), height (m), and mid-upper arm circumference (cm) were measured. Body mass index (kg/m2) was determined from the weight and height of the patients. Data entry was done by Epi-data (version 3.4) and analyzed using SPSS (version 26.0). Associations between variables were determined using logistic regression. A p-value of