Xerosis, characterized by dry skin, is a frequent manifestation in patients undergoing maintenance hemodialysis. Understanding the prevalence of xerosis in this population and exploring its associations with various clinical and laboratory parameters is crucial for comprehensive patient care. The present study aimed to estimate the prevalence of xerosis in patients undergoing maintenance hemodialysis and to investigate the association between xerosis and various clinical and laboratory parameters, with a specific focus on serum copeptin as a surrogate for antidiuretic hormone. Methods. This cross-sectional observational study was conducted at the Hemodialysis Clinic of the Basrah Nephrology and Transplantation Center from March 1, 2022, to September 1, 2022. The prevalence of xerosis and its correlation with clinical characteristics and serum copeptin status were analyzed. Results. The study findings indicate that among the 48 patients undergoing maintenance hemodialysis, with an average age of 59.8 ± 8.8 years, 60.4% presented with xerosis. Serum copeptin levels, measuring 3.8 ± 2 ng/mL, showed a significant association with diuretic usage and serum parathyroid hormone (PTH) (p < 0.001 and p = 0.031, respectively). Notably, no correlations were observed with other demographic or laboratory parameters, despite the tendency of serum copeptin levels to be higher in females and patients with low serum albumin and PTH concentrations. Conclusions. In summary, xerosis was prevalent in 60.4% of patients undergoing maintenance hemodialysis and demonstrated a positive correlation with diuretic use and serum PTH levels.