Objective To evaluate the effects of hemodialysis in elderly patients with chronic renal failure. Methods Observed and summarized the clinical data of 65 elderly patients suffering from CRF who received hemodialysis, analyzed the survival, the cause of death, the complications during dialysis, the dialysis adequacy and nutritional status. Results The long term survival rate of elder patients increased gradually. The commonest causes of death were cardiovascular events, infection and malnutrition. Hypotension was the most common cardiovascular complication. The dialysis adequacy and nutritional status improved, but serum albumin was significantly lower than that in non-elder patients. Conclusion Providing individual HD treatment, improving nutritional stutus and controlling infection may contribute to the increasing of survival rate and the redcution of the complications.