【Abstract】Objective To explore the red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) on the prognosis of maintenance hemodialysis (MHD) patients. Methods Clinical data of the end-stage renal disease (ESRD) patients treated with regular dialysis for more than 3 months and with stable condition in the Hemodialysis Center of the First Affiliated Hospital of Bengbu Medical College from January 1, 2017 to December 31, 2018 were retrospectively analyzed. Patients were divided into two groups based on the difference of RDW, and the general conditions and hematological indicators such as RDW were compared between the two groups. Patients were also divided into two groups based on the presence or absence of adverse events, and their RDW and NLR were compared between the two groups. Kaplan-Meier curve and COX regression model were used to analyze RDW and NLR for independent prediction of prognosis in MHD patients. Results A total of 221 MHD patients with the age of 56.3±13.1 years old and dialysis age of 31.0 (8.0, 58.9) months were included in this study. Adverse events were found in 68 patients, in which 29 cases died and 39 cases had non-fatal events. In the adverse event group, the mean RDW and NLR were higher than those in the non-event and survival group (Z=2.642 and 5.044 respectively; P=0.009 and <0.001 respectively). COX regression analysis showed that time mean RDW (HR=1.300, 95% CI: 1.000～1.691, P=0.049) and