Aim To determine whether the degree of carotid atherosclerosis is associated with left ventricular hypertrophy(LVH) in maintenance hemodialysis(MHD) patients. Methods Thirty-six MHD patients were included in this study. Their biochemical parameters,including C-reactive protein before hemodialysis,creatinine,blood urea nitrogen (BUN),total cholesterol,haemoglobin,plasma albumin,calcium,phosphorus and parathormone were examined by routine methods. The anatomy,hemodynamics,atheromatous plaque and intima media thickness(IMT) of bilateral carotid artery,carotid bifuracation and carotid internal artery were measured by color Doppler. The left ventricular end-diastolic dimension,left atrium diameter,interventricular septum thickness at end diastole,left ventricular posterior wall thickness at end diastole,right ventricular outflow tract diameter,right ventricular diameter,stroke volume,cardiac output and left ventricular ejection fraction were also detected by ultrasonic cardiography. The left ventricular mass index was calculated as well. Results The plaque-positive was detected in 24 of the patients (67%). The plaque-positive patients had elder age,longer dialysis time,more C-reactive protein,lower plasma albumin(P<0.05). And the plaque-positive patients had higher intima media thickness of carotid,interventricular septum thickness at end diastole and left ventricular mass index. Conclusion The carotid atherosclerosis is associated with LVH in MHD patients. Whether the treatment of atherosclerosis may cause regression or even prevent LVH in MHD patients remains to elucidate.