Abstract: Objective To study the association of serum sclerostin level with coronary artery calcification in maintenance hemodialysis (MHD) patients. Methods The clinical data of 138 patients receiving MHD during January 2016 to January 2017 in Hemodialysis Center of our hospital were collected. Patients were examined for serum sclerostin levels and related clinical data, CT-assisted detection of coronary artery calcification score. Multivariate logistic regression was used to analyze the correlation between sclerostin and coronary artery calcification in MHD patients. The ROC curve was used to analyze the diagnostic value of sclerostin in MHD patients. Results Logistic regression analysis showed that sclerostin was an independent risk factor for coronary artery calcification (OR=1.362, 95% CI=1.073-1.724, P=0.032). The analysis on the ROC curve of sclerostin for coronary artery calcifications revealed AUC=0.826, 95% CI=0.759-0.892, P=0.000. The diagnostic value of slerostin was 47.71 ng/L, the diagnostic sensitivity was 0.607, and the specificity was 0.938. Conclusions The high concentration of sclerostin is an independent risk factor for coronary artery calcification in MHD patients. It is significant for sclerostin to diagnose coronary artery calcification in MHD patients.