Objective  To investigate in vitro the expression of Toll-like receptor 2 in endothelial cells in response to the serum from maintenance hemodialysis (MHD) patients with acute coronary syndrome (ACS).  Methods   Human umbilical vein endothelial cells（HUVEC）were treated in vitro with serum from the healthy subjects (control group), the MHD patients with stable angina pectoris (SA group) or the MHD patients with ACS (ACS group) .  The cells in ACS group were cultured in the presence or absence of TLR2 signaling blockers.  After 18h，the cells and supernatants were collected, and the mRNA level for TLR2, nuclear factor-κB（NF-κB), interleukin-6（IL-6）and vascular cell adhesion molecule-1（VCAM-1）were examined by Real-time qPCR, the localization of TLR2 was detected by immunocytochemistry, The secretion of IL-6 and VCAM-1 were measured by enzyme-linked immunosorbent assay.  Results  The mRNA level of TLR2, NF-κB and IL-6 were statistically higher in the ACS group when compared with those in SA group and healthy controls (P<0.05), and showed no difference between SA and healthy controls. The secretion of IL-6 in ACS group were increased when compared with SA group and control subjects (P<0.05).  When the HUVEC were cultured with the anti-TLR2 antibodies, the expression of NF-κB, IL-6 and VCAM-1 mRNA as well as IL-6 and VCAM-1 were significantly inhibited (P<0.05).  Conclusion  This study revealed that the TLR2 signaling may mediate pro-inflammatory response in the MHD patients occurring with ACS.