Background: Chronic kidney disease (CKD) is a major systemic condition associated with chronic inflammation, immune dysfunction, and multiple oral manifestations. Patients undergoing maintenance hemodialysis are considered highly susceptible to poor oral hygiene and periodontal disease. Periodontitis may further contribute to systemic inflammatory burden and negatively affect the overall health status of CKD patients. However, periodontal health among hemodialysis patients often remains neglected in routine clinical care. Objectives: To assess the oral hygiene status among chronic kidney disease patients undergoing maintenance hemodialysis and to determine the prevalence and severity of periodontitis among them. Methods: A hospital-based cross-sectional observational study was conducted among 107 CKD patients undergoing maintenance hemodialysis at K H Patil Institute of Medical Sciences. Participants were recruited using consecutive sampling technique. Oral hygiene and periodontal assessment were carried out using Oral Hygiene Index-Simplified (OHI-S), Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, clinical attachment loss, and Community Periodontal Index. Periodontal status was classified according to the 2017 World Workshop Classification of Periodontal Diseases. Chi-square test was applied wherever appropriate. A p-value <0.05 was considered statistically significant. Results: The majority of study participants demonstrated fair to poor oral hygiene status. Bleeding on probing was present among 67.3% of patients. The prevalence of periodontitis was found to be 85.0%, with Stage III periodontitis being the most common presentation. Poor oral hygiene status showed a statistically significant association with periodontitis (p<0.001). Duration of hemodialysis was also significantly associated with increasing severity of periodontal disease (p=0.004). Conclusion: CKD patients undergoing maintenance hemodialysis demonstrated poor oral hygiene and a high prevalence of moderate-to-severe periodontitis. Regular periodontal screening and integrated dental care should be incorporated into routine management of hemodialysis patients to improve oral and overall health outcomes.