Aim To determine whether chronic inflammatory status is associated with carotid atherosclerosis in maintenance hemodialysis (MHD)patients. Methods Twenty-five MHD patients and fifteen healthy volunteers were included in this study. The levels of high-sensitive C-reactive protein (hs-CRP) and tumor necrotic factor-α (TNF-α) were used to assess the chronic inflammatory status measured by ELISA. Intima-media thickness (IMT) and prevalence of atherosclerotic plaques of the extracranial common carotid artery were measured by high-resolution B mode ultrasonography. Results The levels of plasma hs-CRP and TNF-α in the MHD patients were higher than those in the healthy volunteers. The prevalence of atherosclerotic plaques and the mean IMT value of carotid artery significantly increased in MHD patients compared with those in age and sex-matched controls. Age and the levels of plasma transformed TNF-α were positively correlated to CCA-IMT (r=0.733,p<0.001;r=0.792,p<0.001) respectively. Multiple stepwise regression analysis showed that in MHD patients, the independent risk factors associated with value of IMT were plasma transformed TNF-α levels, age, high density lipoprotein cholesterol (HDLC), CRP, phosphorus, apolipoprotein B, prior albumin and triglyceride. Conclusion Chronic inflammatory status is really present in MHD patients; inflammation plays a role in the pathogenesis of atherosclerosis in these patients.