Purpose <p>To investigate the effect of music therapy on pain and comfort levels in hemodialysis patients.</p> Methods <p>The study was completed with 30 experimental patients and a 30-member control group receiving treatment in the hemodialysis unit in a hospital in Western Türkiye. Experimental group patients were allowed to listen to a form of music selected by them for approximately 6&#xa0;min prior to each procedure. No procedure was performed on the members of the control group. A Visual Analog Scale (VAS) was applied in sessions 1, 6, and 12, and the Hemodialysis Comfort Scale in sessions 1 and 12. The independent sample t test and repeated-measures analysis of variance were employed in data analysis, and Cohen’s d in effect size calculations.</p> Results <p>Hemodialysis Comfort Scale scores were significantly higher at the end of the study in the experimental group compared to the control group (SMD: 3.54, 95% CI 2.33–4.75) (<i>p</i> &lt; 0.05). Mean VAS scores were significantly lower among the experimental group compared to the control group at the second (6th session) (SMD: 1.94, 95% CI 1.34–2.54) (<i>p</i> &lt; 0.001) and third (12th session) evaluations (SMD: 3.2, 95% CI 1.2.65–3.75) (<i>p</i> &lt; 0.001). VAS scores were also significantly lower in the experimental group at the third evaluation compared to the earlier evaluations (<i>p</i> &lt; 0.05).</p> Conclusion <p>The patients in the experimental group listened to a form of music of their choice before 12 hemodialysis sessions. Music was found to exhibit a positive effect on pain and discomfort in patients receiving hemodialysis.</p> Trial registration <p>NCT05574595.</p>