This study aimed to explore meaning of living with End Stage Renal Disease undergoing hemodialysis of Muslims in Pekanbaru, Indonesia. This study was an ethnographic study conducted in Pekanbaru, Indonesia. 4 females and 8 males Muslims on hemodialysis were recruited using purposive sampling. The inclusion criteria were Muslims, being diagnosed with End Stage Renal Disease and having known the diagnosis, having been undergoing hemodialysis at least 6 months, and never change treatment to peritoneal analysis or renal transplantation. Data were collected using in-depth interviews, participant observation and documentation of field note. Data analysis used the ethnonursing data analysis method. Findings of the study revealed 3 categories; (1) restricted life, (2) life is struggle, and (3) reminder to God. Results of this study suggest nurses and other healthcare professionals should understand principles of religions and cultures in their community to help them provide culturally congruent care for their patients.