<i>Background:</i> The objective was to investigate the status of vascular calcification, and to explore factors influencing vascular calcification in maintenance hemodialysis patients. <i>Methods:</i> Vascular calcification was quantitatively evaluated using radiographic films of the abdomen, pelvis and hands. Plasma fetuin-A and other parameters related to calcification were examined. <i>Results:</i> 33/50 cases of vascular calcification were identified by radiographic film. Calcifications of the abdominal aorta and peripheral muscular arteries were seen in 90.9 and 36.4%. Patients with moderate to severe calcification were older, more likely to be male, had lower diastolic blood pressure and fetuin-A levels, and a higher incidence of diabetes than those with mild calcification. Logistic regression analysis showed that diabetes and plasma fetuin-A were independent risk factors for vascular calcification. <i>Conclusions:</i> Vascular calcification was present in a large proportion of maintenance hemodialysis patients, most frequently in the abdominal aorta. Diabetes and plasma fetuin-A levels were independent risk factors for vascular calcification in maintenance hemodialysis patients.