Abstract: Objective To investigate the prevalence and risk factors of skin abnormality in patients with chronic renal failure （CRF） on maintenance hemodialysis. Methods One hundred and eighty-one patients with CRF on maintenance hemodialysis were examined for skin abnormality. The following data were collected from patients: age, gender, ultrafiltration volume, urea clearing index （Kt/V）, blood pressure, levels of hemoglobin, serum albumin, lipid, calcium phosphorus product and parathyroid hormone, etc. Results Skin abnormalities were observed in 88.95% of these patients. Among them, 23.60% had one kind of abnormality, 32.30% had two, 24.84% had three, 16.15% had four, and 3.11% had five. The most common manifestation was xerosis （77.72％, 128/181）, followed by pruritus （55.80％, 101/181）, epidermal desquamation （40.33％, 73/181） and cutaneous pigmentation （38.67％, 70/181）. Other cutaneous disorders included skin pallor （3.31％, 6/181）, ecchymosis （2.21％, 4/181）, mummification necrosis of digits（1.10%, 2/181）, foot ulcer （1.66％, 3/181）, onychorrhexis （0.55％, 1/181,）. The levels of dialysis duration, ultrafiltration volume, serum phosphonium, calcium phosphonium product, serum parathyroid hormone, high sensitivity C-reactive protein, positivity rate of hepatitis B virus and hepatitis C virus markers were significantly higher in the hemodialysis patients with skin abnormalities than in those without, while the levels of hemoglobin and Kt/V were significantly lower in the hemodialysis patients with skin abnormalities than in those without. As shown by logistic regressive analysis, the levels of dialysis duration, Kt/V, serum calcium phorsphorum product, serum parathyroid hormone, high sensitivity C-reactive protein, and the presence of hepatitis C virus were the independent risk factors for the occurrence of skin abnormalities in hemodialysis patients. Conclusions There is a high prevalence of skin abnormality in patients with CRF on maintenance hemodialysis, and, xerosis and pruritus are the most common skin abnormalities.