【Abstract】 Objective To investigate the causes of death and their related factors in maintenance hemodialysis (MHD) patients. Methods We retrospectively analyzed 306 patients who had treated with MHD for more than 3 months during the period between January 2000 and January 2008. At the end of the observation period, 71 of the patients died, 134 remained to be treated with MHD, and 101 went out of the MHD treatment course for various reasons. Age, sex, primary diseases, blood pressure, inter-dialysis weight gain, Kt/V, hemoglobin (HGB), hematocrit (HCT), serum creatinine before hemodialysis (Scr.PHD), and serum albumin (ALB), total cholesterol (CHO), triglyceride (TG), calcium (Ca), phosphorus (P) and parathyroid hormone (PTH) were compared between the death cases and the survival cases. Correlation analysis was also made for the risk factors relating to death. Results The causes of death were cardiac complications (25 cases, 35.21%), cerebrovascular diseases (23 cases, 32.39%), generalized failure (8 cases, 11.27%), serious infections (8 cases, 11.27%), and malignant tumors (6 cases, 8.45%). Older mean age (P＜0.01), lower values of HGB, HCT, ALB, Kt/V, Scr.PHD and PTH (P＜0.001 or P＜0.05) and higher serum CHO (P＜0.01) were found in the death cases than in the survival cases. Conclusions Cardiac complications, cerebrovascular diseases, generalized failure and serious infections are the common causes leading to death in HMD patients. The main risk factors relating to death include elder age, anemia, hypoalbuminemia, hypercholesterolemia, insufficient Kt/V and lower Scr. PHD.