Objective To study the relationship between serum fibroblast growth factor-23(FGF-23) and cardiovascular calcification in patients with end-stage renal disease(ESRD). Methods A total of 60 ESRD patients were included in this study,the calcification of their abdominal aortas and cardiac valves was qualitatively assessed by both lateral-position plain radiography of abdomen and echocardiography,and FGF-23 by enzyme-linked immunosorbent assay(ELISA).A routine laboratory test was done for detection of serum creatinine(Scr),calcium(Ca),phosphorus(P),alkaline phosphotase(ALP),total cholesterol(TC),hemoglobin(HB),and immunoreactive parathyroid hormone(iPTH) was detected by electrochemilluminescence method.Forty individuals who joined physical examination were served as controls. Results The levels of FGF-23 in ESRD patients were higher than that in the control,the difference was significant(t=7.50,P0.01).A correlation analysis indicated that serum FGF-23 level was positively correlated with Scr,P,iPTH and ALP(r=0.411-0.675,P0.01),and not correlated with serum Ca,TC,TG,and HB(r=-0.113——0.012,P0.05).Serum FGF-23 was higher in ESRD patients with cardiovascular calcification than those without(t=5.40,P0.01). Conclusion The rising of serum FGF-23 in ESRD patients is closely related with occurrence and development of cardiovascular calcification.