Objective：To investigate the risk factors of coronary artery calcification（CAC）in maintenance hemodialysis（MHD）patients. Methods：A total of 188 stable MHD（≥3 months）patients were enrolled in the study，their baseline characteristics and laboratory measurements were collected，coronary artery calcification score（CACS）was measured by multi-slice computed tomography（MSCT），the risk factors for CAC were analyzed. Results：CAC（CACS>100）was present in 54.8%（103/188）patients，the median CACS was 143（0，728）. In comparison with the CACS<100 group，age，dialysis vintage，serum calcium，alkaline phosphatase（ALP）and intact parathyroid hormone（iPTH）levels were significantly higher than those in CACS≥400 group（P < 0.05）. Spearman correlation analysis revealed that CACS were positively correlated with age（r=0.292，P < 0.001），dialysis vintage（r=0.242，P=0.001），systolic pressure（r=0.167，P=0.024），serum calcium（r=0.263，P < 0.001），iPTH（r=0.191，P=0.009）and ALP（r=0.171，P=0.019）. With multivariate linear regression analysis，serum ALP was the only biomarker which showed significant correlation with CACS. Receiver operating characteristic（ROC） curve analysis showed that the area under curve（AUC） of ALP predicted severe CAC was 0.615（P=0.009），the optimal cutoff value was 226.5 U/L. By logistic regression analysis，serum ALP≥226.5 U/L was a robust predictor of CAC and was associated with the likelihood of CACS≥400（odds ratio 3.05，95% confidence interval 1.30 to 7.18，P=0.011）. Conclusion：Serum ALP level is a potential independent predictor of CAC in MHD patients. ALP is suggested to be a promising predictor and interventional target for cardiovascular calcification in MHD patients.