Objective  To investigate the distribution characteristics of forearm artery calcification in maintenance hemodialysis patients and its correlation with vascular access.   Methods   Patients who received regular hemodialysis treatment in the Blood Purification Center of the First Hospital of Hebei Medical University from January 2023 to July 2023 were selected. Clinical data were collected. Doppler ultrasound was used to examine the radial artery and ulnar artery of both upper limbs, and the calcification score was recorded.  Results  A total of 118 patients were included. The overall prevalence of radial artery and ulnar artery calcification: the prevalence of ulnar artery calcification on the non-fistula side was higher than that of radial artery calcification (P=0.029), with a statistical difference. There were no significant difference of the prevalence of calcification between the ulnar artery and radial artery (P=0.557). In addition, the prevalence of calcification on the internal fistula side of the radial artery was significantly higher than that on the non-internal fistula side (P=0.015). The prevalence of calcification was no significant difference between ulnar artery fistula side and non-fistula side (P=0.405). The prevalence of calcification in different segments of the radial artery and ulnar artery: the prevalence of calcification in the distal segment of the radial artery and ulnar artery was higher than that in the proximal segment, regardless of the internal fistula side or the non-internal fistula side (P =0.001；P＜0.001；P＜0.001；P＜0.001). Comparison of the severity of vascular calcification: the degree of calcification in the ulnar artery was more severe than that in the radial artery (χ2=14.524, P=0.024), the difference was statistically significant. The calcification degree of the ulnar artery on the non-fistula side was more severe than that of the radial artery (χ2=17.522, P=0.004), and the difference was statistically significant. The degree of calcification of the radial artery in the fistula side was more severe than that in the non-fistula side (χ2=12.943, P=0.044). The severity of ulnar artery calcification on the fistula side was basically the same as that on the non-fistula side (χ2=6.733, P=0.346).  Conclusions   The prevalence and severity of vascular calcification in the distal segment of the upper extremity artery in maintenance hemodialysis patients are higher than those in the proximal segment, and the ulnar artery may be more susceptible to calcification.