Objective To explore the prevalence of low bone mineral density (BMD) in patients undergoing maintenance hemodialysis (MHD) and relevant influencing factors. Methods A total of 144 patients undergoing MHD in the Hemodialysis Center of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in April, 2014 were enrolled. The BMD values of lumbar spine and hip were measured by the dual energy X-ray absorptiometry (DEXA). Levels of serum alkaline phosphatase (AKP), calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25 hydroxy vitamin D [25 (OH) D3] were detected. Correlations among BMD, clinical characteristics [such as gender, age, body mass index (BMI), and dialysis age], and examination indexes were analyzed. Results Among 144 enrolled patients undergoing MHD, 85 patients were male and 59 patients were female. The prevalence of osteoporosis and osteopenia were 19.44% and 30.56%, respectively. The prevalence of osteoporosis of females (28.8%) was higher than that of males (12.9%) and the difference was statistically significant (P=0.029). Results of correlation analysis showed that BMD positively correlated with BMI and negatively correlated with dialysis age and serum AKP and iPTH levels. Conclusion Based on standardized treatment of osteoporosis, the incidence of low BMD of patients undergoing MHD is still as high as 50%. Gender, dialysis age, BMI, and serum AKP and iPTH levels closely correlate with BMD.