Catheter-related bloodstream infection (CRBSI) is a major cause of morbidity, vascular access loss, and mortality in hemodialysis patients with stage V chronic kidney disease (CKD). Pseudomonas aeruginosa forms biofilms on catheter surfaces, and it is intrinsically non-susceptible to tigecycline, so this agent has no role in its treatment. This case report aims to report and analyze a case of probable CRBSI caused by P. aeruginosa in a patient with a temporary double-lumen catheter, based on anamnesis, physical examination, and laboratory data, including blood culture, supported by a literature review of pathophysiology, diagnosis, and management. A 36-year-old woman with stage V CKD on routine hemodialysis presented with shortness of breath, fever, and leg swelling, accompanied by signs of systemic infection, leukocytosis, and elevated C-reactive protein. A blood culture drawn from a peripheral vein on hospital day 6 grew P. aeruginosa that was susceptible to piperacillin-tazobactam, ceftazidime, cefepime, aztreonam, meropenem, amikacin, and ciprofloxacin and resistant to tigecycline. She had been treated empirically with ceftriaxone, which has no reliable antipseudomonal activity, from hospital day 1; it was changed to meropenem when the result became available on day 7, and the catheter was retained. She died on hospital day 9. In hemodialysis patients with persistent fever and a catheter, blood cultures should be obtained early, empiric therapy should cover Gram-negative organisms, including P. aeruginosa, according to the local antibiogram, and the catheter should be reassessed promptly, together with strict infection control, to reduce morbidity and mortality.