〔Abstract〕 Objective To investigate the correlation between the cerebral gray-matter volume changes and Montreal Cognitive Assessment Scale(MoCA), cerebral structure of end-stage renal disease(ESRD) is evaluated by using voxel-based morphometry(VBM). Methods 47 patients with end-stage renal disease(ESRD group) and 46 normal volunteers(control group) underwent T1 WI structure scanning and MoCA tests. The DPABI software was used to preprocess the cerebral structure data, independent samplet-test was performed for cerebral structure data of two groups, and the difference of brain regions was obtained by using SPM 12(P<0.05,FWE corrected). Pearson correlations between volume of brain regions of difference and MoCA score were conducted by using SPSS(P<0.05). Results Compared with healthy control group, gray-matter volume of ESRD group decreased in the left caudate, left parahippocampal gyrus, left anterior cingulate gyrus, left transverse temporal gyrus, left middle frontal gyrus, left anterior insula, bilateral middle cingulate gyrus, right temporal pole and right precentral gyrus medial segment(allP<0.05,FWE corrected). The volume of the left anterior cingulate gyrus positively was correlated with MoCA score, attention, language and abstract score(P<0.05), that of the left anterior insula positively was correlated with MoCA score, visual and executive ability, attention score(P<0.05), that of the left middle cingulate gyrus positively was correlated with attention score(P<0.05), and that of the right precentral gyrus medial segment positively was correlated with language score(P<0.05). Conclusion The volume of some brain regions of ESRD patients decreases, involving left anterior/middle cingulate gyrus, left anterior insula and right precentral gyrus medial segment. The brain regions are mainly related to cognitive, attention and language.