Back ground and purpose: Hemodialysis patient are susceptible to muscle cramps, both during dialysis sessions as well as in the interdialytic interval, these cramps are often very painful disruptive to dialysis management & adversely affect quality of life there no well defined mean of preventing or treating these cramps. Exercises have been used with apparent success in some patient. Exercises is very important element in the overall health of people at any age stretching exercises may be the best measure to reduce or prevent cramps from occurring. So the present study was designed to determine the effect of stretching exercises protocols on reduction of leg cramp during hemodialysis among patient with renal failure. Quasi- experiment ( research design was applied. This study was conducted in kidney dialysis department of Assiut university hospitals. The subjects of this study consists of 60 patient with muscle cramps during hemodialysis. three tools included in the study, tools of soci - demographic data ,tools of patient information about muscle cramps & management & tool of evaluated patient knowledge & skills after performance exercises. Results: there was lack of knowledge & skills related to muscle cramps before nursing instruction protocol but there was statistical significant difference after performance of exercises. It was found also that high significance difference between before & after performance of exercises. Conclusions: the importance of performance exercises for patient undergoing dialysis to prevent cramps. there is clearly a need for effective education regarding recognition ,individual patient need & appropriate intervention strategies in muscle cramps in dialysis patient & nurses, in partnership with patient, relatives & careers & other health professional can help to empower the individual to mange their cramps.