Aim To evaluate coronary artery calcification(CAC) by multislice spiral CT scan in patients starting to undergo hemodialysis,and to analyse its association with cardiovascular events in the follow-up. Methods 29 patients starting to undergo chronic hemodialysis(duration of hemodialysis under 6 months) were enrolled in this study.CAC score,along with related parameters,was quantified by Multislice Spiral CT scan at the initiation of this study.The patients were followed up for about 18 months for appraising cardiovascular events. Results 18 cases of CAC(62.07%) were identified by CT scan in 29 patients starting to undergo chronic hemodialysis,with average CAC score being 482.41±739.97.During the 18 months follow-up,significant difference of cardiovascular events was documented among patients with CAC(22 times) and without CAC(1 time)(P=0.001).CAC was independently associated with cardiovascular events(Spearman's Rho=0.882,P<0.0005).Stepwise regression analysis in 29 patients indicated that CAC score was related with age and serum PO4(P=0.013,P=0.043).However,CRP,Ca,iPTH,Chol,TG,HDL-C,LDL-C,BMI,SBP and DBP were excluded from this regression equation(P>0.05). 6 cases(15.79%) were died of cardiovascular events during the 18 months follow-up,including 5 cases with CAC and 1 case without CAC.Kaplan-Meier survival analysis showed that there was no significant difference between patients with CAC and without CAC(P=0.2930). Conclusion Multislice Spiral CT based coronary artery calcification scoring is helpful in risk evaluation of cardiovascular events of hemodialysis patients.