OBJECTIVE To determine patient and dialysis services-related factors associated with seroconversion of hepatitis C virus (HCV) in hemodialysis (HD) patients. METHODS Cross-sectional study. METHODS Department of Nephrology, Mayo Hospital, King Edward Medical University (KEMU), Lahore, from January to December, 2018. METHODS All patients on regular HD for more than three months were enrolled. All patients who seroconverted from HCV-negative to positive status three months after starting HD, were included. Patient-related factors (age, gender, blood transfusion, duration and frequency of dialysis, history of dental treatment and surgical intervention) and dialysis services-related parameters (dedicated staff, isolated room, hemodialysis machine, reverse osmosis plant, compliance of universal infection control measure) were noted. RESULTS Out of 990 patients, 492 (49.7%) were reported as seroconverted for HCV during HD. Factors determined statistically significant for seroconversion were surgical intervention (p<0.001), history of dental procedure (p <0.001), blood transfusions (p <0.001), multiple sexual partner (p <0.001), age (p=0.035) and duration of hemodialysis (p <0.001). Factors not affecting seroconversion included frequency of dialysis (p=0.062), history of renal transplant (p =0.097) and family history of hepatitis (p=0.941). A significant negative correlation was observed between the rate of seroconversion of HCV and the score of universal infection control measures (r=-0.665, p=0.018). CONCLUSIONS There was a high rate of seroconversion of HCV in HD patients. Factors responsible for seroconversion were history of surgical intervention, dental treatment, blood transfusion, multiple sexual partners, age and duration of dialysis. The dialysis centres non-compliant with universal infection control measures were having high rate of seroconversion. Key Words: Hemodialysis, Seroconversion, HCV, Blood transfusion, Dental treatment, Surgical intervention, Infection, Isolation.