Objective: To investigate the changes in serum levels of receptor for advanced glycation end products(RAGE) and vitamin D receptor(VDR) in patients with maintenance hemodialysis(MHD) and their relationship with vascular calcification. Methods: From December 2019 to December 2020, 105 patients with MHD who were treated in the hemodialysis room of our hospital for more than 6 months were gathered as the research objects. Among them, 30 cases were in the non- calcification group, 45 cases in the mild calcification group, and 30 cases were in the severe calcification group. Enzyme-linked immunoassay was performed to measure the RAGE and VDR levels; Pearson method was performed to analyze the correlation between RAGE and VDR expression; receiver operating characteristic(ROC) curve was performed to evaluate the value of serum RAGE and VDR levels in the diagnosis of vascular calcification in MHD patients; multivariate Logistic regression analysis was used to analyze the influencing factors of vascular calcification. Results: The expression level of VDR in the severe calcification group was lower than that in the non-calcification group and the mild calcification group, and the mild calcification group was lower than the non-calcification group; the expression level of RAGE of patients in the severe calcification group was higher than that in the non-calcification group and the mild calcification group, and the mild calcification group was higher than the non-calcification group, the differences were statistically significant(P<0.05). Compared with the non-calcification group, the levels of serum parathyroid hormone(iPTH), blood calcium(Ca), blood phosphorus(P) and calcification scores in the mild calcification group and severe calcification group were increased(P<0.05); RAGE was directly correlated with iPTH, blood Ca, blood P, and calcification score, and VDR was inversely correlated with iPTH, blood Ca, blood P, and calcification score(P<0.05). Pearson method analysis showed that the expression of RAGE and VDR in serum of MHD patients was obviously nagatively correlated(r=-0.345, P<0.05); Logistic regression analysis showed that VDR, RAGE, iPTH, blood Ca, and blood P were all independent risk factors affecting the occurrence of vascular calcification(P<0.05); the ROC curve showed that the area under the curve(AUC) of VDR and RAGE levels predicting vascular calcification in MHD patients was 0.902 and 0.861, respectively, the corresponding sensitivity was 78.67% and 74.67%, and the specificity was 90.00% and 86.67%. The joint predicted AUC was 0.905, the sensitivity was 72.00%, and the specificity was 96.67%. Conclusion: The degree of vascular calcification in MHD patients is related to the expression of RAGE and VDR. The expression of RAGE increases with the severity of vascular calcification, and the expression of VDR decreases with the severity of vascular calcification. The combined detection of the two has a high diagnostic efficiency for the occurrence of vascular calcification in MHD patients.