The present study investigated the effectiveness of structured exercise programme on muscle cramps among patients undergoing maintenance haemodialysis at Govt. Medical College Hospital, Kottayam. A quantitative research approach was used for the study. The study was theoretically supported by Betty Neuman’s system model. A total of 60 patients, 30 each in control and experimental group, were selected for the study using simple random sampling technique. The data were collected using socio personal and clinical data sheet, urea reduction ratio assessment chart, fatigue assessment scale and muscle cramp assessment scale. Pre test was conducted by assessing muscle cramps on the day of dialysis prior to first day of intervention. After pre test, on the 1st day of intervention the investigator provides sufficient explanation and demonstrated the method of exercises before dialysis to the experimental group and thereafter the patients were instructed to perform it during haemodialysis with the help of an audio under the supervision of the investigator. Each of the movements were repeated for 10 times for a period of 10 minutes every 20 minutes during the first 2 hours of dialysis, twice in a week for four weeks .The post test for muscle cramps was done on 8th dialysis in both control and experimental group. The results of the study revealed that structured exercise programme had significant effect muscle cramps (p<0.001) among patients undergoing maintenance haemodialysis.