Background: Reduced salivary flow has been reported in patients undergoing hemodialysis (HD) treatment. Our aim was to investigate the most important factors associated with stimulated salivary flow rate (ssfr) in chronic HD patients. Methods: Fifty HD patients (27 F, 23 M, mean age 46. 7 ± 13.2 years) were divided into two groups according to the duration of HD treatment as those receiving HD therapy less than or equal to (group I) or those more than (group II) 24 months. Fasting blood samples were obtained to determine hepatitis B and C serology, and biochemical and hematological parameters before a HD session. After prestimulation with a standard weight paraffin wax, stimulated saliva was collected in the HD patients and control group (23 F, 25 M, mean age 45.7 ± 19.1 years) and the flow rate was expressed as ml/min. Results: Both HD groups consisted of 25 patients. There was no significant difference between the two HD groups other than serum alkaline phosphatase (ALP) levels and presence of HCV. The ssfr was decreased than controls in both groups (0.8 ± 0.6 and 0.7 ± 0.4, respectively, vs. 1.5 ± 0.5 ml/min) and it did not correlate with any parameter. Smoking had a positive effect on ssfr in all groups. Conclusion: Although the salivary flow rate decreased significantly in chronic HD patients, the duration of therapy displayed no effect on the salivary changes in HD patients, but smoking increased ssfr.