Background <p>Long-term hemodialysis significantly impacts the lives of patients and their families, creating a range of psychosocial and economic challenges. Social support and resilience are critical in enabling patients to navigate these difficulties and restore balance. This study investigated the relationship between perceived social support and resilience in patients undergoing hemodialysis.</p> Methods <p>This inferential cross-sectional study was conducted from April to July 2022, involving patients undergoing hemodialysis at two major centers in western Iran. Three hundred patients were selected through convenience sampling based on specific inclusion and exclusion criteria. Data were gathered using a demographic information form, the Multidimensional Scale of Perceived Social Support, and the Connor-Davidson Resilience Scale. The data were analyzed using SPSS version 24 software, employing descriptive and analytical statistical methods.</p> Results <p>The results indicated a significant positive correlation between perceived social support and patients’ resilience (<i>r</i> = 0.391, <i>p</i> = 0.001). Multivariable linear regression analysis revealed that resilience was significantly associated with perceived social support (β = 0.384, <i>p</i> = 0.001), educational level (β = 0.151, <i>p</i> = 0.018), marital status (β = 0.139, <i>p</i> = 0.036), gender (β = 0.134, <i>p</i> = 0.014), and income level (β = 0.128, <i>p</i> = 0.025).</p> Conclusion <p>The study findings demonstrate a strong positive correlation between perceived social support and resilience in patients undergoing hemodialysis. Therefore, health professionals are recommended to enhance resilience through psychosocial interventions (e.g., support groups and counseling) and family empowerment models.</p> Clinical trial number <p>Not applicable.</p>