Aim To explore the value of neutrophil/lymphocyte ratio (NLR) in predicting CAC by analyzing the risk factors of coronary artery calcification (CAC) in dialysis patients. Methods 163 dialysis patients (including 102 hemodialysis patients and 61 peritoneal dialysis patients) were retrospectively studied using a cross-sectional survey method. Based on the Agatston’s coronary calcification score (CACS), the patients were divided into two groups:non-calcification group (CACS 0~10), and calcification group (CACS≥11). NLR, age, dialysis history, levels of high sensitivity C-reactive protein (hs-CRP), calcium, phosphorus, total parathyroid hormone (iPTH), albumin (Alb), hemoglobin, and serum creatinine were calculated and compared between the two groups. Spearman correlation was used to analyze the factors related to CAC, binary Logistic regression analysis was used to evaluate the risk factors of CAC, and the receiver operating characteristic (ROC) curve was used to explore the predictive value of NLR for CAC. Results The total detection rate of CAC in 163 dialysis patients was 63.8%. NLR was higher in calcification group (n＝104) than that in non-calcification group (n＝59) (P＜0.001). Patients with calcification were divided into mild calcification group(CACS 11~400)and severe calcification group (CACS＞400), there was no difference in NLR between the two subgroups. Spearman correlation analysis showed that the NLR was significantly correlated with CAC (r＝0.403, P＜0.001). Binary Logistic regression analysis showed that age (OR=1.069, P＜0.001), dialysis age (OR=1.024, P＜0.001), diabetes (OR=15.871, P＝0.012) and NLR (OR=1.720, P＝0.001) were risk factors for CAC. ROC curve analysis results showed that when using the combined index of NLR and age to predict CAC in dialysis patients, the area under the curve was 0.810 (95%CI 0.739~0.880, P＜0.001), which was significantly higher than NLR (0.2,5%CI 0.666~0.818, P＜0.001) and age (0.4,5%CI 0.674~0.834, P＜0.001) when analyzed separately under the curve. Conclusion Dialysis patients with advanced age and high levels of NLR have a higher risk of CAC, and the combination of NLR and age has a better predictive value for the occurrence of CAC.