
Non –traumatic subarachnoid hemorrhage (SAH) is an uncommon occurrence in hemodialysis patients and has been infrequently reported in medical literature so far. We report a case of spontaneous, non-aneurysmal SAH in a young maintenance hemodialysis patient with a poor outcome. The dialysis prescription following bleeding needs to be modified in these patients in order to prevent further worsening of cerebral oedema and progression of hemorrhage. Switch over to peritoneal dialysis or continuous forms of renal replacement therapies with regional anti-coagulation is the best option for such patients till neurologic stabilization is achieved.