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Objective To observe the prevalence of osteoporosis and to investigate the associations between bone mineral density (BMD) and serum biochemical markers in maintenance hemodialysis patients，and to explore the risk factors of osteoporosis． Methods One hundred and twenty-five patients undergoing hemodialysis were selected． The general data and dialysis-related information were collected． The levels of 25 － hydroxyvitamin D，bone-specific alkaline phosphatase，and BMD at the calcaneus were measured． Statistical analysis was performed using the SPSS version 19. 0． P ＜ 0. 05 was accepted as statistically significant． Ｒesults The prevalence of osteoporosis was 48% and 25-hydroxyvitamin D deficiency was 30. 4% in maintenance hemodialysis patients． No statistically difference of the prevalence of osteoporosis was found between the genders． BMD was significantly lower in post-menopausal women than in pre-menopausal women (P ＜ 0. 001) ． 25-hydroxyvitamin D was significantly lower in female patients than in male patients (P = 0. 026)． BMD was significantly lower in tubulointerstitial nephritis patients than in chronic glomerulonephritis patients (P = 0. 001)． BMD was lower in patients with sedentary lifestyle (P ＜ 0. 001) ． BMD was negatively correlated with age and duration of hemodialysis (r = － 0. 387，P ＜ 0. 001，r = － 0. 190，P = 0. 034，respectively) ． Older age， post-menopause，low body weight，sedentary lifestyle，and renal transplantation were risk factors for osteoporosis in maintenance hemodialysis patients． Conclusion The prevalence of osteoporosis and 25 － hydroxyvitamin D deficiency are high in maintenance hemodialysis patients，but no association is found between them． Older age，post-menopause，low body weight，sedentary lifestyle， and glucocorticoid and immunosuppressant therapy after renal transplantation are risk factors for osteoporosis in maintenance hemodialysis patients． [ABSTRACT FROM AUTHOR]