【Abstract】Objective To observe the number of proliferative parathyroid glands and the ultrasonic signal characteristics in hemodialysis patients with secondary hyperparathyroidism examined by color Doppler ultrasonography. Methods A total of 86 patients were divided into two groups: dialysis age <8 years group, and dialysis age > 8 years group. The number, length, width, thickness and volume of proliferative glands were evaluated by using color Doppler ultrasonography. Serum biochemical parameters and the color Doppler images were recorded. Surgically removed parathyroid glands were subjected to pathological examination. Results There were statistical differences in number and volume of proliferative glands, serum parathyroid hormone (PTH), and phosphorus levels between the dialysis age <8 years group and the dialysis age > 8 years group. The correlation between PTH level and the volume of proliferation glands was found in the dialysis age > 8 years group but not in the dialysis age <8 years group.  Conclusions Color Doppler ultrasonography is a simple and effective method to detect proliferative parathyroid glands and to provide information about treatment approaches.