Background: Influenza infection can cause severe complications and hospitalization in patients with end-stage renal disease. Despite the importance of influenza vaccination in preventing such complications, adherence to vaccination among these patients is often inadequate.Objective: To investigate the factors that predict influenza vaccination adherence among patients undergoing in-center dialysis in Taif City, Saudi Arabia.Methods: Analytical cross-sectional study was conducted in dialysis units of different hospitals in Taif City, Saudi Arabia. A predesigned questionnaire was used for data collection which included questions related to sociodemographic characteristics, knowledge about influenza vaccination, perceived risks of influenza infection, and vaccine-related questions.Results: A total of 463 individuals were included in the analysis. The median score for knowledge was 6/10, with 60.9% of patients demonstrating good knowledge. In terms of vaccination status, 64.1% had received the influenza vaccine for the current year, with 47.3% adhering to yearly vaccination, 23.1% receiving vaccines irregularly, and 29.6% never receiving the vaccine. Among those who did not receive the vaccine, 21.8% were concerned about the side effects, 15.1% did not believe in the vaccine's effectiveness, and 14.5% were influenced by the media. Adherence to vaccination was significantly associated with good knowledge (OR=2.4), a higher perceived risk of hospitalization (OR=2), and a higher perceived risk of death (OR=2.2).Conclusion: In conclusion, the study reports predictors that influence influenza vaccine adherence among patients receiving dialysis in Saudi Arabia. Furthermore, the study highlights the importance of knowledge, perceived risk, and healthcare workers' advice in influenza vaccine adherence among patients receiving dialysis.