Background: Hemodialysis patients frequently experience anxiety and sleep disturbances due to long-term treatment dependence and psychosocial stress. Spiritual-based interventions such as Quranic Murottal therapy may improve psychological well-being; however, empirical evidence remains limited. Objective: This study aimed to examine the effectiveness of Murottal therapy of Surah Al-Insyirah accompanied by its translation on anxiety and sleep quality among hemodialysis patients. Methods: A quasi-experimental pretest-posttest control group design was conducted involving 88 hemodialysis patients selected using simple random sampling. Participants were equally assigned into intervention and control groups. The intervention group received Murottal therapy of Surah Al-Insyirah with Indonesian translation for 10 minutes across four sessions over two weeks, while the control group received healing prayer. Anxiety and sleep quality were measured using the Beck Anxiety Inventory (BAI) and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using Wilcoxon signed-rank and Mann-Whitney U tests. Results: Significant reductions in anxiety and improvements in sleep quality were observed in the intervention group compared with the control group (p < 0.001). Conclusion: Murottal therapy of Surah Al-Insyirah effectively reduces anxiety and improves sleep quality among hemodialysis patients. Implications for Nursing: This intervention may be integrated into holistic spiritual nursing care for hemodialysis patients..