Objective   To analyze the occurrence of sarcopenia in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (MHD) and summarize its influencing factors.Methods  Retrospective analysis of 250 ESRD patients with regular MHD admitted to the Blood Purification Center of Huai′an First Hospital Affiliated to Nanjing Medical University from January 2018 to December 2022 as the study subjects. Based on the occurrence of sarcopenia, the patients were divided into a group with concomitant sarcopenia (120 cases) and a group without concomitant sarcopenia (130 cases). The differences of anthropometric indicators and Modified Quantitative Subjective Global Assessment (MQSGA) were compared, and the influencing factors of sarcopenia were analyzed by multiple logistic regression.Results  The grip strength, body mass index (BMI), limb skeletal muscle mass index, 4 m walking speed, prealbumin, albumin, and body protein content of the group with sarcopenia were lower than those of the group without sarcopenia.  The levels of age, β2microglobulin, MQSGA score, and C-reactive protein (CRP) of the group with concomitant sarcopenia were higher than those in the group without sarcopenia（all P<0.05）. Multivariate logistic regression analysis showed that age, grip strength, body protein BMI, MQSGA score, CRP were closely related to the occurrence of sarcopenia in ESRD with MHD（all P<0.05）.Conclusions  ESRD patients with MHD have sarcopenia that is independently related to age, grip strength, body protein content, BMI, MQSGA score, CRP level, etc., and should be highly valued.