OBJECTIVES: To examine the indications for hospitalisations among haemodialysis patients. DESIGN: A retrospective observational study. SETTING: Alnoor Kidney Centre in Al Noor Specialist Hospital, Makkah City, Saudi Arabia, which is a Ministry of Health hospital. PARTICIPANTS: Participants were prevalent patients with end-stage renal disease on regular haemodialysis in 2011, who had received haemodialysis for more than three months. Each patient was followed up retrospectively, from the first date of initiating haemodialysis to the end of 2011. MAIN OUTCOME MEASURES: (i) The primary reasons for hospital admissions and (ii) risk factors that increase the number of hospital admissions and which increase length of stay in hospital. RESULTS: The primary reasons for hospital admissions associated with increases in the length of stay in hospital were diseases of the circulatory system (which increased hospital bed days by 70%; 95% CI: 11-161%; p value = 0.01 compared to all other reasons). The risk factors that increased the number of hospital admissions per patient-year at risk were increasing age (incidence rate ratio [IRR] = 1.02 per 1 year of age; 95% CI: 1.01-1.03; p value = < 0.0001); receiving haemodialysis through a catheter compared to arteriovenous fistula (IRR = 2.55; 95% CI: 1.14-4.97; p value = 0.001) and diabetes as a cause of renal disease compared to hypertension (IRR = 1.84; 95% CI: 1.29-2.63; p value = 0.001). CONCLUSION: Indications for hospitalisation and consequences of practices related to hospitalisation for haemodialysis patients should be studied in further research to provide a comprehensive evidence-based management policy for haemodialysis patients in Saudi Arabia.