Abstract: Objective To explore the influencing factors of eosinophilia in peripheral blood of maintenance hemodialysis patients and examine its relationship with prognosis. Methods From January 1 to January 31, 2018, 114 MHD patients at dialysis center of our hospital were retrospectively selected and divided into two groups of A(>5%) and B(<5%) according to the proportion of eosinophil. The inter-group differences in baseline profiles and laboratory tests were analyzed. They were followed up for 45 months. Logistic model was utilized for examining the factors related to all-cause endpoint events and receiver operating characteristic(ROC) curve for analyzing the predictive efficacy of elevated eosinophil ratio on all-cause endpoint events. Results Significant inter-group differences existed in gender, coronary heart disease, cardiac function grade Ⅲ/Ⅳ, high-sensitivity C-reactive protein, dialysis adequacy (Kt/V), pre-dialysis calcium(Ca), ferritin, parathyroid hormone(iPTH) and all-cause endpoints(P<0.05). After adjusting for various confounding factors, Logistic analysis revealed a significant correlation between all-cause endpoints and elevated proportion of eosinophils(P=0.03, 95%CI 1.013-1.281). The area under the curve(AUC) of predicting all-cause endpoint was 68% with a sensitivity of 68% and a specificity of 74.6%. Conclusion Inflammatory status, iPTH and pre-dialysis calcium are the influencing factors of elevated eosinophil ratio. And elevated eosinophil ratio is an independent risk factor for allcause endpoint events in MHD patients.