Arteriosclerosis is a serious and slowly developing vascular lesion, and is frequently detected in end stage kidney disease (ESRD) patients in recent years. It triggers the progression of cardiovascular and cerebrovascular diseases, profoundly affecting prognosis of the patients and even leading to death. The clinical manifestations of arteriosclerosis are usually insidious and easily to be neglected in hemodialysis patients. In this paper we introduce the recent advances in the risk factors, prevention and treatment of arteriosclerosis in maintenance hemodialysis patients, in order to prevent the occurrence of arteriosclerosis and improve the prognosis of these patients.