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The aim of this study is to assess the impact of pharmaceutical care on medication adherence, hemoglobin (Hb) levels, blood pressure (BP), and interdialytic weight gain (IDW) among hemodialysis (HD) patients. An open-label randomized controlled study has been conducted at three different hospitals of HD centers. The patients have been randomized into two groups [usual care group (UCG) and pharmaceutical care group (PCG)] by block design. The assessment has been carried out at baseline, 6th, and 12th months. At the end of the study, a total number of 153 patients have been followed. Out of 153 patients, 83 (UCG: n = 41; PCG: n = 42), 18 (UCG: n = 09; PCG: n = 09), and 52 (UCG: n = 25; PCG: n = 27) patients have been followed from academic, government, and corporate hospitals, respectively. The PCG had significantly reduced its IDW and BP levels in comparison to UCG at different time intervals with a statistical significance of P <0.05. The Hb levels and medication adherence rate scores of HD patients had significantly increased in PCG compared to UCG at different time intervals. The “World Health Organization-International Pharmaceutical Federation pharmaceutical care” plan model delivered by the registered pharmacist regarding the knowledge about the disease, medications, life style changes, nutritional information, personal interview, and medication review had a positive impact on the on medication adherence, Hb levels, BP, and IDW.