Abstract: Chronic kidney disease (CKD) represents a critical global public health challenge with significant implications for human morbidity and mortality. As a principal renal replacement therapy for end-stage renal disease (ESRD), hemodialysis (HD) relies fundamentally on the performance of its core component — the hemodialysis membrane. This review provides a comprehensive analysis of recent advancements in hemodialysis membrane technology, encompassing membrane classification, functional properties, material characteristics, and modification strategies. We systematically evaluate emerging membrane designs and perform comparative assessments of commercial hemodialysis membranes, while critically analyzing current limitations and proposing future research directions. Contemporary hemodialysis membranes (polyethersulfone, polyacrylonitrile, etc.) exhibit persistent challenges in three key performance parameters: clearance efficiency for small-to-medium molecular weight uremic toxins, hemocompatibility, and stable membrane flux. Current research demonstrates that these limitations could be addressed through structural modulation of membrane architecture, precise optimization of pore size distribution, and advanced surface modification techniques including chemical grafting and physical modification. Future developmental trajectories will likely focus on enhanced hemocompatibility, multifunctional integration and miniaturization of hemodialysis membranes (bacterial cellulose membrane, mixed matrix membrane, microfluidic PDMS membrane, etc.), aiming to simultaneously achieve enhanced therapeutic efficacy and improved patient compliance through portable solutions. These innovations are expected to address the growing clinical demand for high-performance dialysis systems that balance treatment efficiency with enhanced quality of life for ESRD patients.