Objective To investigate the relationship be tween hyperhomocyseinemia and cardiovascular structure and function in hemodialy sis patients. Methods Plasma total homocysteine (tHcy) levels were meas ure by fluorescence polarization immunoassay. Carotid Intima-Media thickness (IMT) and cardiovasculars tructure were measured by GEVV5 echocardiography. Cardiovascular parameters inc luding carotid Young's elastic index, left ventricular mass index, ejection fraction, left ventricular end diastolic volume index, E/A ratio were calculated by established formule. Results The prevalence of hyperhomocyseinemia was 68.3% in the hemodialysis patients. The mean level of tHcy in hemodialysis patients was (27.75±8.97)μmol/L which was significantly higher than that in the healthy con trols tHcy level was (8.8 7±2.35) μmol/L( P＜0.05). The prevalence of hyperhomocyse inemia was 82.4% in the hemodialysis patients with abnormal cardiovascular struc ture. Carotid IMT, carotid Young's elastic index, end-diastolic interventricular septum thickness were positively and independently correlated with tHcy the value were 0.34, 0.31 and 0.23 respectively. Multivariate stepwise regression indicated that the correlation also existed independently of other conventional risk factors such as age, sex blood pressure, Scr and glucose, While l eft ventricular ejection fraction and E/A was negatively correlated with tHcy(r= -0.35 and -0.21 respectively). Conclusions The results indicate that hyperhomocyseinemia may be an independent risk factor for cardiovascular disease in hemodialysis pa tients and it may affect cardiovascular structure and function.