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Introduction. Smoking is common in chronic hemodialysis patients, who have a high cardiovascular risk. Patients and methods. This is a multicenter cross-sectional study conducted over a period of 4 months, from July 2021 to October 2021, in the Agadir province of Morocco. Results. Among the 245 patients interviewed, 9.4% were current smokers and 16.7% were former smokers. Compared to non-smoking patients, former and current smokers were predominantly male, had more comorbidities, higher diastolic blood pressure, a higher mean ultrafiltration rate, and received more antihypertensive treatments. A multivariate analysis showed that active smoking was significantly associated with the presence of cardiovascular disease. Conclusion. Smoking is an important and modifiable cardiovascular risk factor in chronic hemodialysis patients.