Background: Hemodialysis patients need to refer to dialysis ward continuously .each dialysis takes time at least 3 hours. The need comfort environment. Nevertheless there are some of environmental factors cause discomforts during dialysis. The aim of this study was to explore the perception of end stage renal disease patients about environment al factors which cause discomfort in patients during hemodialysis.

  Methods : this was a qualitative content analysis .twenty four patients were included in the study. We collected the data via semi structured interview in hemodialysis ward for 45-60 minutes. The sampling was started purposeful sampling and continues till data saturation. Data were analyzed in according eight stage of content analysis.

  Results: out of 24 contributors included in study, we concluded 350 primary codes, 19 subcategory, 6 category and 3 themes emerged for environmental factors barriers discomfort. These themed including: 1) suffer of work place condition in unit 2) dissatisfaction for lack of cultural and welfare facilities and suffering and bothering for dialysis equipment malfunction dialysis equipment.

  Conclusion: it seems managers and planners of health filed should consider updating of hemodialysis equipment according needs and technology advances. They should improve work place conditions and cultural and welfare possibility in order to provide appropriates comfort for delivery service promotion.