【Abstract】Objective Through the analysis of multiple related factors in maintenance hemodialysis (MHD) patients in a single center, the factors affecting long-term survival were evaluated for the improvement of survival rate and quality of life in MHD patients. Methods We retrospectively analyzed clinical records of 235 patients treated with MHD for more than 3 months in the Blood Purification Center, the Second Hospital of Shanxi Medical University between January 2010 and December 2017 to explore the impact of related factors on survival of MHD patients. Results Among the 235 MHD patients, 133 were males and 102 were females. The survival rate was 93.7% in one year, 81.4% in three years, 76.2% in five years and 16.4% in ten years. The longest survival patient lasted MHD for 252 months and still survived well. Older age at the first dialysis (RR=1.03, P＜0.001), diabetic nephropathy (RR=2.24, P＜0.001), dialysis frequency <2 times per week (RR=2.34, P＜0.001) and higher blood phosphorus before dialysis (RR=1.34, P＜0.001) increased the risk of death in MHD patients. Autologous arteriovenous fistula beginning from the first vascular access (RR=0.78, P＜0.001), urea clearance index (Kt/V) >1.2 (RR=0.72, P＜0.001) and higher hemoglobin (RR=0.76, P＜ 0.001) and albumin levels (RR=0.61, P＜0.001) decreased the risk of death in MHD patients. Conclusion As the hemodialysis treatment prolonged, the long-term survival rate declined gradually. Older age at the first dialysis, diabetic nephropathy and high levels of blood phosphorus before dialysis were the risk factors for survival. Autologous arteriovenous fistula used earlier, better dialysis adequacy and higher hemoglobin and albumin levels were the protection factors for survival in MHD patients.