Background <p>The COVID-19 pandemic, coupled with China’s stringent “zero-COVID” policy, posed unprecedented challenges for individuals undergoing maintenance hemodialysis (MHD). Access to dialysis care was significantly disrupted by lockdowns, transportation limitations, and the reallocation of healthcare resources. Despite these systemic barriers, the interaction between such constraints and patients’ personal experiences has not been thoroughly investigated. Therefore, this study seeks to explore the lived experiences of individuals receiving MHD in China during the pandemic, with particular attention to their access to care, psychosocial well-being, and coping mechanisms.</p> Methods <p>A descriptive qualitative study was carried out at a tertiary hospital in Chongqing, China. Sixteen adult participants undergoing MHD were purposively recruited to take part in ten semi-structured interviews and one focus group discussion involving six participants. Data collection occurred between November and December 2023, and the information obtained was analyzed using thematic analysis based on Braun and Clarke’s framework to identify major themes and corresponding subthemes.</p> Findings <p>The analysis led to the identification of five major themes and sixteen subthemes that captured the lived experiences of individuals receiving MHD during the COVID-19 pandemic. These themes encompassed systemic barriers to accessing care, perceived uncertainty about infection control and environmental safety, mental health challenges, self-management approaches, and the influence of family, social, and professional support. The findings highlighted the multifaceted difficulties faced by hemodialysis patients during the pandemic, underscoring the vital importance of personalized coping mechanisms and strong social support systems in sustaining treatment adherence and promoting mental well-being.</p> Conclusion <p>China’s pandemic control measures created significant barriers to dialysis access and contributed to heightened psychological distress among patients. In response, many individuals employed self-management strategies to reduce the impact of these disruptions. The findings highlight the need for patient-centered interventions, particularly those aimed at enhancing transportation accessibility, incorporating mental health support, and addressing disparities in rural healthcare. Future studies should adopt integrated qualitative and quantitative methodologies to better inform pandemic preparedness and response strategies for dialysis-dependent populations.</p> Clinical trial number <p>Not applicable.</p>