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Objective: The aim of this article is to translate and adapt the Mishel uncertainty scale to the Spanish context., Method: A cross-sectional study for transcultural adaptation and validation of the Mishel uncertainty scale. The study population were patients with chronic renal disease treated with hemodialysis. The original English version of the "Mishel uncertainty in illness scale" was translated into Spanish, then back-translated into English, and all the discrepancies were resolved after consulting with experts. A panel including 11 experts in renal care assessed this culturally adapted Spanish version, in order to score the content validity. It was administered to 116 patients in order to calculate the psychometric properties scale. Construct validity was calculated using factor analysis, and internal consistency using Cronbach's alpha coefficient. Relationships between variables related to the main theory were analyzed., Results: The Spanish version has 17 items, distributed in 2 dimensions: ambiguity and complexity. A content validity index average of 0.7 and a Cronbach's alpha 0.72. Statistically significant association was found between uncertainty, gender, educational level and disease relapse., Conclusions: Cross-cultural adaptation of the Mishel uncertainty in illness scale preserves equivalence with the original. Content validation identified most useful items for chronic renal patients. The multidimensional nature of the scale is reaffirmed. The association between uncertainty and the level of education is also confirmed., (Copyright © 2014 Elsevier España, S.L.U. All rights reserved.)