【Abstract】 Objective To study the prevalence of hepatitis B virus (HBV) infection, liver function changes by the infection, and the risk factors of the infection in maintenance hemodialysis (MHD) patients. Methods We retrospectively analyzed 301 MHD patients treated for more than 6 months in Shanghai First People’s Hospital Affiliated to Jiaotong University from December 2008 to March 2009. Their hemodialysis period lasted 6-372 months (64.13±61.00 months). The indicators for HBV infection were examined every half a year for all patients. We divided the patients into HBsAg positive and HBsAg negative groups. Before the beginning of hemodialysis, we assayed HBV by the second generation enzyme linked immunosorbent assay (ELISA), liver functions by an automatic biochemical analyzer, and blood routine tests by a blood cell analyzer. Results In the 301 cases, serum HBsAg was found in 20 cases (6.64%); but the infection rate increases to 42.52% if patients with one or more than one HBV infection markers (HBVM) were included. Five HBsAg positive patients (25.00%) and 6 HBsAg negative patients (2.14%) had the history of blood transfusion. Logistic analysis showed that blood transfusion was significantly correlated with patients with serum HBsAg (r=16.597, P=0.000). In HBsAg positive patients, one had liver cirrhosis, and one turned to be negative later. Positive HBsAg did not affect liver function and the quality of dialysis in MHD patients. Conclusions In this cohort of MHD patients, the rate of positive serum HBsAg was 6.64%. Blood transfusion increased the rate of HBV infection. HBV infection had less effect on liver function and complications in these patients. Regular detection of HBV infection and strict isolation measures are essential for the prevention of HBV infection in MHD patients.