Objective To explore the effect of serum lipid level in hemodialysis patients on cardiovascular diseases and the associated factors of cardiovascular disease. Methods Serum total cholesterol, triglyceride, Apo A1, Apo B, Apo E of 106 hemodialysis patients were determined and compared with those of 148 healthy controls. Results The levels of serum TG were significantly higher in hemodialysis patients with cardiovascular diseases. There were also an increase in age, serum creatinine, uric acid, albumin levels pre-hemodialysis and the ratios of hypertension, family histories of cardiovascular disease in these patients. Kt/V, extracorporeal circulating volume during hemodialysis and the amount of ultrafiltration were much lower in these patients than the hemodialysis patients without cardiovascular diseases. Conclusions The results suggest that age, hypertension, serum TG, albumin and phosphorus levels may be the important risk fators of cardiovascular disease. Serum albumin, extracorporeal circulating volume during hemodialysis, serum bile acid levels and Kt/V values are closely related to lipid metabolism disorders, which may induce the lipid metabolism disorders in hemodialysis patients more severely.