Purpose: This study is to identify how the meaning in life, depression, and social support influences the suicidal ideation of old adult hemodialysis patients. Methods: A cross-sectional design was used. A descriptive correlative study was conducted through an organized and structured self-administrated questionnaire survey for 120 sampled old adult renal dialysis patients. The collected data were analyzed by t-tests, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis using the Stata 13.0 program. Results: The suicidal ideation of participants was positively correlated with the meaning in life, and social support, and the depression was negatively correlated with the suicidal ideation. Significant factors influencing the suicidal ideation included the meaning in life, depression, social support, age, caregiver, monthly income, and smoking. These factors explained 68% of the variance. Conclusion The depression of old adult hemodialysis patients was a major risk factor that increased suicidal ideation, and the meaning in life and social support was a protective factor that reduced the suicidal ideation. These results suggest that health professionals should provide old adult hemodialysis patients with proper management of suicidal ideation, and depression as well as its meaning in life, and social support.