Objective  To observe the effect of paricalcitol on secondary hyperparathyroidism(SHPT) in maintenance hemodialysis patients. Methods  From July 2018 to July 2019, 56 SHPT maintenance hemodialysis patients with poor efficacy of nonselective vitamin D receptor activator(VDRA) or intolerance to calcimimetics or unwilling to operate from several hospitals in Hunan province were selected. According to the level of serum intact parathyroid hormone (iPTH), all patients were divided into three groups, group A(300 pg/mL≤iPTH＜600 pg/mL), group B(600 pg/mL≤iPTH 800 pg/mL) and group C(iPTH≥800 pg/mL). Patients received different doses of intravenous paricalcitol injection based on their body weight. The levels of iPTH, blood calcium, blood phosphorus and calcium phosphorus product before treatment, initial treatment for 1 month, and when reaching the maintenance dose of paricalcitol were measured. Results  Patients' symptoms such as bone pain, itching, fatigue improved. After 1 month of initial treatment, the iPTH compliance rate of all patients was 51.8%(29/56), and the percentage of patients reaching the maintenance dose of paricalcitol was 57.1%(32/56). Serum iPTH at 1month of initial treatment was significantly decreased compared with prior treatment[(718.76±457.56) pg/mL vs. (956.68±375.61)pg/mL,P<0.001]. There was no significant change in serum calcium, serum phosphorus and calcium phosphorus product before and after treatment[(2.28±0.23) mmol/L vs.(2.23±0.27)mmol/L,(2.15±0.49)mmol/L vs.(2.29±0.48)mmol/L, (58.49±17.71)mg²/dl² vs.(62.90±13.93)mg²/dl²,P>0.05]. Compared with initial treatment, serum iPTH of patients entering maintenance therapy still declined, but the difference was not statistically significant[(424.82±221.23) pg/mL vs.(517.55±325.77)pg/mL,P>0.05]. There was no significant change in serum calcium, serum phosphorus and calcium phosphorus product between initial treatment with maintenance treatment[(2.33±0.20)mmol/L vs.(2.31±0.24)mmol/L, (2.13±0.44)mmol/L vs.(2.00±0.42)mmol/L, (61.24±12.25)mg²/dl² vs.(55.76±15.66)mg²/dl²,P>0.05]. Conclusions  Paricalcitol treatment has good curative effect on SHPT in maintenance hemodialysis patients with poor efficacy with poor efficacy of nonselective VDRA or intolerance to calcimimetics or unwilling to operate, which can relieve the symptoms of bone pain, itching, fatigue, reduce the level of serum iPTH significantly, and dose not increase the risk of hypercalcemia.