Objective To investigate serum C-reactive protein (CRP) level and its correlation with erythropoietin (EPO) resistance. Methods Ninety-six maintenance hemodialysis patients (including 56 men and 40 women), aged (50.6±14.9) years were studied. Blood samples were collected at the day on hemodialysis for the determination of serum albumin, iron indicts, fibrinogen, CRP, hemoglobin (Hb) and hematocrit (Hct). The EPO resistance was defined according to the recombinant human erythropoietin (rHuEPO) dosage to Hct (EPO/Hct) ratio. Results Patients in elevated serum-CRP group (57 cases，59.4％) had higher dosage of rHuEPO, EPO/Hct ratio, and fibrinogen level, but lower levels of serum albumin, Hb and Hct, as compared with the patients in normal serum-CRP group (39 cases， 40.6％). Multiple stepwise regression analysis showed that the levels of serum albumin, serum-CRP and the duration of hemodialysis were the best predictors of EPO/Hct (R2=0.338, P=0.039). Conclusions There is a prevalence of microinflammatory state in the maintenance hemodialysis patients. The microinflammatory state is the most important predictor of the EPO resistance.