There is a great risk of cardiovascular disease (CVD) and vascular thrombosis in patients with End-Stage Renal Disease (ESRD). These patients exhibit numerous abnormalities in coagulation, fibrinolytic, inhibitory protein abnormalities in multiple levels. The study aimed to assess hypercoagulable changes by measuring the levels of antithrombin, plasma fibrinogen and FXII activity in patients with ESRD, and to find their correlation with Hemoglobin (Hb) level, WBC count, reticulocyte percentage and platelet count. This study was conducted at Al-Hayat center, Al Karama Teaching Hospital on 50 ESRD patients aged < 60 years of both genders. In addition, 20 apparently healthy individuals were included as a control group. The mean Hb level, total WBC count, absolute neutrophil count, reticulocyte percentage and platelet count were significantly lower in ESRD patients than control (P<0.05). The mean values of prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen and Factor XII activity were significantly higher in patients than controls. Antithrombin activity was significantly lower in patients group than controls (P<0.001). Cardiovascular complications and vascular thrombosis including deep venous thrombosis( DVT), cerebrovascular accident (CVA), myocardial infarction (MI), angina or heart failure were reported in 62% of the patients who had significantly higher PT, APTT, and factor XII activity, and lower antithrombin activity as compared to those without cardiovascular complication and vascular thrombosis. In conclusion, ESRD patients had coagulation abnormalities rendering them more liable to have cardiovascular complications and vascular thrombosis.