Objective To explore the relationships among perceived exercise benefits, perceived exercise barriers, exercise self-efficacy and exercise intention in patients with end-stage renal disease （ESRD）, and to provide reference for the establishment of effective exercise rehabilitation intervention programs in clinical practice. Methods A total of 249 patients with ESRD were investigated by using the general information questionnaire, Dialysis Patient-perceived Exercise Benefits and Barriers Scale, Self-efficacy for Exercise Scale, and Exercise Intention Questionnaire. Results The scores of exercise intention of ESRD patients was 14.0（12.0,14.0）, the perceived exercise benefits was 37.0（34.0,39.0）, the perceived exercise barriers was 33.0（30.0,35.0）, and the exercise self-efficacy was 40.0（36.5,44.0）; The results of structural equation model showed that the perceived exercise barriers had a direct negative effect on exercise intention （β=-0.230,P＜0.05）, exercise self-efficacy had a direct positive effect on exercise intention （β=0.246,P＜0.05）.Exercise self-efficacy played a complete mediating effect in the influence of perceived exercise benefits on exercise intention, and played a partial mediating effect in the influence of perceived exercise barriers on exercise intention, explaining 15.13% of the variability. Conclusion Exercise self-efficacy plays a mediating role in the influence of perceived exercise benefits and barriers on exercise intention in patients with ESRD, and medical staff should take measures to reduce the impact of perceived exercise barriers on patients′ exercise intention, help them gradually adapt to exercise and build self-confidence, so that patients have the intention to participate in dialysis rehabilitation exercise.