The pituitary gonadal axis of men with chronic renal failure is disturbed even when there is moderate reduction of the glomerular filtration rate. This axis is also disturbed in the ageing male. The present investigation was undertaken to study the pituitary gonadal hormonal response in Saudi male patients, belonging to two different age-groups, on regular hemodialysis (HD). Male patients on HD were divided into two groups. Group one included 24 individuals under 45 years of age and group two had 50 subjects > 45 years. Age-matched healthy individuals were used as controls. Serum levels of total and free testosterone were significantly reduced in patients> 45 years of age when compared to patients < 45 years of age. Also, the levels of follicle stimulating hormone (FSH) and leutenizing hormone (LH) were significantly increased in both the groups when compared with their age-matched controls. However, the serum levels of FSH, LH and sex hormone binding globulin (SHBG) were not significantly different between patients> 45 years and those < 45 years of age. Similarly, there was no significant difference in the hemoglobin levels between the two groups. The results of this study, suggest that disturbances in the pituitary gonadal hormonal responses in men on HD and> 45 years of age may be more severe than men < 45 years of age. Further studies are warranted to understand this observation.