Objective  To investigate the relationship between dietary phosphorus-to-protein ratio (DPR) and biochemical parameters, quality of life (QoL) in maintenance hemodialysis (MHD) patients, providing evidence for phosphorus metabolism management.  Methods  A total of 110 patients receiving regular dialysis at our blood purification center from May 2023 to May 2025 were enrolled. DPR was assessed using a 3-day dietary record method. Patients were divided into low-DPR group (＜16.8mg/g, n=36), medium-DPR group (16.8～20.2 mg/g, n=37), and high-DPR group (＞20.2 mg/g, n=37). The Kidney Disease Quality of Life Short Form (KDQOL-SF) was used to evaluate QoL. Pearson correlation analysis was used to examine associations between DPR and biochemical indicators and QoL.  Results  A total of 110 patients were included, with 36, 37, and 37 patients in the low-DPR, medium-DPR, and high-DPR groups, respectively. As DPR increased, the levels of serum phosphorus (F=15.678, P＜0.001), calcium-phosphorus product (F=7.892, P＜0.001), iPTH (F=12.567, P＜0.001), CRP (F=7.234, P=0.001), and IL-6 (F=5.678, P=0.005) increased sequentially, while the levels of serum calcium (F=10.234, P＜0.001), albumin (F=5.234, P=0.007), and prealbumin (F=4.567, P=0.013) decreased sequentially. The differences between groups were statistically significant. The total score of KDQOL-SF in the high DPR group (52.0±15.1) was significantly lower than that in the low DPR group (66.1±14.2) (F=10.789, P＜0.001). Pearson correlation analysis showed that DPR was positively correlated with serum phosphorus (r=0.596, P＜0.001), iPTH (r=0.548, P＜0.001), calcium-phosphorus product (r=0.512, P＜0.001), and CRP (r=0.367, P＜0.001); and negatively correlated with serum calcium (r=-0.445, P＜0.001), albumin (r=-0.324, P＜0.001), and total KDQOL-SF score (r=-0.478, P＜0.001). Among them, DPR had the strongest correlation with disease-specific total score (r=-0.501, P＜0.001).  Conclusions  DPR in MHD patients is significantly correlated with calcium-phosphorus metabolic disorders, malnutrition, chronic inflammation and impaired quality of life. Elevated DPR serve as an important correlator factor for abnormal mineral metabolism and reduced quality of life. Clinicians should attach importance to dynamic monitoring and targeted intervention of DPR for dialysis patients. And dietary recipes should be optimized under sufficient daily protein intake to improve patients’ clinical outcomes and overall life quality.