Purpose: In the present study, the difference in patients' nursing demands and nursing performance as perceived by the patients was examined. Methods: The participants were 272 patients on maintenance hemodialysis at five university hospitals. Nursing need and nursing performance were measured using the tool developed by Lee for this study. Results: The mean score for nursing demand was 3.35 points out of 4. The scores were higher for participants with middle school graduation or less, those not professing religion, and those whose medical insurance was of the medicaid type. The mean score for perceived nursing performance was 3.22 points out of 4. Nursing performance as perceived by hemodialysis patients was lower than nursing demand for 22 of 28 items. The item with the largest difference between nursing performance and nursing demand was 'Give a pain-free injection', followed by 'Explain about insurance benefits and supports' and 'Maintain quiet environment in the hemodialysis unit enabling rest during hemodialysis'. Conclusion: The results show that nursing performance as perceived by hemodialysis patients was lower than nursing demand. This result indicates a need to develop appropriate strategies to enhance nursing performance, especially for items that showed low nursing performance.