The purpose of the study was to examine the quality of life and illness acceptance among ESRD patients with the moderating effects of death anxiety. The cross-sectional design was incorporated. The sample was comprised of 240 participants. Individuals with ESRD on hemodialysis were approached above 20 years of age. A self-administered questionnaire was used for data collection. The results revealed that COVID-19 has a significant impact on the quality of life of patients and their illness acceptance. Covid-19 affected the general health of patients, their psychological health, as well as their social relationships. The results also confirmed that death anxiety negatively moderates the relationship between quality of life and illness acceptance among ESRD patients. This study will shed light on the need to provide appropriate psychosocial care as well as supportive therapies to people with end-stage renal disease who are experiencing mental distress during and after the COVID-19 outbreak.