Malnutrition is a common complication in chronic kidney disease (CKD) patients on hemodialysis, increasing morbidity and mortality. Limited data exist regarding the nutritional status of Sudanese hemodialysis patients. To assess protein–energy malnutrition (PEM/PEW) in hemodialysis patients at Kassala Kidney Center using biochemical and anthropometric markers. This case-control study included 140 participants (70 hemodialysis patients, 70 healthy controls). Blood samples were analyzed for albumin, total protein, hemoglobin, calcium, creatinine, urea, sodium, and potassium. Body mass index (BMI) was calculated. Data were analyzed using SPSS v.16, with independent t-tests; P<0.05 was considered significant. Hemodialysis patients had significantly lower BMI, albumin, total protein, hemoglobin, and calcium compared to controls (P<0.0001), while urea, creatinine, sodium, and potassium were significantly elevated (P<0.0001). Based on BMI and albumin, 40% of patients were malnourished. Albumin correlated positively with BMI (r=0.707, P<0.0001) and hemoglobin (r=0.561, P<0.0001). Malnutrition is prevalent among Sudanese hemodialysis patients. Routine nutritional assessment, dietary counseling, and monitoring of biochemical markers are essential to improve patient outcomes.