Patients with end-stage renal disease are at increased risk for the development of uremic pericarditis or dialysis-associated pericarditis, and either comorbidity can be complicated by pericardial effusion. Patients with end-stage renal disease complaining of dyspnea and chest pain demand a robust differential diagnosis, which can delay an appropriate intervention. Here we describe a patient with pericarditis and hemopericardium causing symptomatic pericardial effusion.Keywords: Uremic hemopericardium, uremic pericarditis, pericardiocentesis