Abstract Background Chronic kidney disease-associated pruritus (CKD-aP) is a common condition in patients treated with hemodialysis, and has a negative impact on Quality of life (QoL). Due to the lack of standardized diagnostic tools and frequent underreporting, pruritus prevalence remains poorly documented. Methods Pruripreva was a prospective multicenter observational study aimed to evaluate the prevalence of moderate to severe pruritus in a cohort of French hemodialysis patients. The primary end point was the rate of patients with mean Worst Itch Numerical Rating Scale (WI-NRS) ≥4 calculated over 7 days (moderate pruritus, 4–6; severe, 7–8; very severe, 9–10). Impact of CKD-aP on quality of life was analyzed according to its severity (WI-NRS), using 5-D itch scale, EQ-5D and SF-12. Results Mean WI-NRS was ≥4 in 306 patients (mean age, 66.6 years; male, 57.6%) out of 1304 and prevalence of moderate to very severe pruritus was 23.5% (95% CI, 21.2-25.9). Pruritus was unknown prior to the systematic screening in 37.6% of patients, and 56.4% of those affected were treated for this condition. More severe was the pruritus, poorer was the QoL according to the 5-D itch scale, EQ-5D and SF-12. Conclusion Moderate to very severe pruritus was reported in 23.5% of hemodialysis patients. CKD-aP was underrated although it is associated with a negative impact on QoL. These data confirm that pruritus in this setting is an underdiagnosed and underreported condition. There is an urgent demand for new therapies to treat chronic pruritus associated with CKD in hemodialysis patients.