Abstract: Objective To evaluate the function and structure of the heart and to investigate the relationship between left atrial volume index (LAVI) with left ventricular systolic and diastolic function, left ventricular mass index(LVMI) in hemodialysis patients. Methods One hundred and one patients on maintenance hemodialysis were recruited. Doppler echocardiogram examinations were performed by one well-trained physician in ultrasonography on interdialytic days. The following measurements were obtained: end systolic volume(ESV), end diastolic volume(EDV), ejection fraction(EF%). From the mitral inflow profile, the ratio of early (E) to late atrial (A) mitral Doppler peak flow velocity (E/A ratio) was calculated as an index of left ventficular diastolic function. LAV was calculated by the biplane method of discs at the end of left ventricle systole. LAVI and LVMI were analyzed as body surface area indexed estimates. Results The mean age was 62.6±10.8 years and median duration of hemodialysis was 52（12,218） months. The mean LAVI was 34.7±14.4ml/m2. The mean LVMI was 145.5±57.3g/m2. The mean EF was 63.3%±10.8% and the mean E/A ratio was 0.80±0.27. Augmentation in LAVI was present in 50.6% of the patients. There were statistical differences in E/A ratio and EF% between patients with LAVI > 32 ml/m2 and patients with LAVI≤ 32ml/m2. LAVI was negatively correlated with EF%（r=-0.311，p=0.033）, as well as with E/A ratio（r=-0.346，p=0.013）, and was positively correlated with duration of hemodialysis（r=0.267，p=0.042）, as well as with LVMI（r=0.319，p=0.029）, but was not correlated with age and gender. In multiple stepwise regression analysis, E/A ratio（β=-0.324，p=0.018）was identified as an independent variable for the LAVI. Conclusion Enlargement in LAVI was prevalent in hemodialysis patients. Determination of the changes in LAVI by echocardiogram is very important to evaluate left ventricular diastolic function and to predict the morbidity of cardiovascular events.