Background: Hemodialysis patients experience physical and psychosocial symptoms caused by comorbid illnesses, treatment-related side effects, lifestyle alteration, and the psychosocial impacts of living with end-stage renal disease. The Dialysis Symptom Index (DSI) is the most frequently used instrument to assess symptoms of chronic kidney disease and end-stage renal disease in patients. Purpose: The aims of this study were to develop the Korean version of the DSI, to verify the reliability and validity of the developed tool, and to use the tool to evaluate the symptoms of hemodialysis patients in Korea. Methods: A methodological study was performed on 230 hemodialysis patients from three hospitals who agreed to participate in the study from October 1 to 30, 2015. The Symptom Checklist- 90-Revised was used to verify the convergent validity, whereas the total score of Kidney Disease Quality of Life Questionnaire- Short Form, Version 1.3, was used to verify the divergent validity. Data were analyzed using descriptive analysis, Cronbach_s alpha, confirmatory factor analysis, and Pearson_s correlation analysis. Results: The internal consistency reliability of the Korean DSI assessed by Cronbach_s alpha was .90. The Korean DSI showed a high positive correlation coefficient of .80 with symptom severity using the Symptom Checklist-90-Revised, which confirmed the convergent validity. Finally, the correlation coefficient with the quality of life of the participants using the Kidney Disease Quality of Life Questionnaire-Short Form, Version 1.3,wasj.68, which confirmed the divergent validity. Conclusions/Implications for Practice: This study developed the Korean version of the DSI and verified its validity and reliability. The Korean version of the DSI showed good properties and may be used to assess the symptoms of hemodialysis patients. Nurses may use this self-report tool to better understand and help relieve the prevalence and severity of symptoms in hemodialysis patients in Korea.