This case report describes a 69-year-old male patient with end-stage renal disease who presented with neurological symptoms of uremic encephalopathy including slurred speech, muscle twitching, and weakness. The patient's symptoms improved with hemodialysis treatment. Uremic encephalopathy occurs when toxins accumulate in the brain due to kidney failure. Hemodialysis is effective at removing toxins and resolving associated neurological manifestations.