Background & Aim: Chronic kidney disease is a major health concern in Egypt, often requiring lifelong hemodialysis. Muscle cramps are among the most frequent complications during hemodialysis, affecting wellbeing and overall quality of life, especially in the elderly patients. Intradialytic stretching exercises provide a safe approach helping in reducing cramp severity reducing stress level, the current study aimed to evaluate the effect of intradialytic stretching exercises on elderly patients’ muscle cramps and stress. Methods & Materials: A quasi-experimental design was used via a purposive sample of 100 elderly (50 cases & 50 control). Three tools were used; structured interview questionnaire (sociodemographic data & medical history), cramp questionnaire chart and DAS (21). Results: A significant reduction in the severity of muscle cramps from 52% as moderate and 46% as severe before intervention to 42% mild and 30% moderate after intervention at (p<0.01). Significant difference in stress, stress-free patients increased from 38% to 52% at (p<0.01). Conclusion: Intradialytic stretching exercises proved to be an effective tool in alleviating muscle cramps and reduce stress level among elderly hemodialysis patients. Recommendations: Tailor training for dialysis nurses emphasizing the crucial role of intradialytic stretching exercise in reducing muscle cramps, reducing stress level, and improving quality of live for elderly hemodialysis patients.