〔Abstract〕 Objective To explore the level of secreted phosphoprotein 24(SPP24) and its association with cardiac valve calcification(CVC), cardiovascular events(CVE) in patients with hemodialysis patients. Methods Eighty-eight maintenance hemodialysis patients were enrolled in the study. All patients were assessed for cardiac valve calcification by echocardiography. According to the results of echocardiography, patients were divided into two groups: cardiac valve calcification group and the group without cardiac valve calcification. The levels of SPP24 were measured by enzyme-linked immunosorbent assay. Serum SPP24 levels were compared between CVC group and the group without cardiac valve calcification. Binary logistic regression was used to evaluate the association between SPP24 and cardiac valve calcification. The factors for calcification of the mitral and aortic valves were explored. The cases were followed up and cardiovascular events were recorded. COX regression model was used to analyze the factors for cardiovascular events. Results There were 47 patients in CVC group, the levels of SPP24 in CVC group were lower than those in the group without cardiac valve calcification(P=0.040). Twenty-two patients had calcification of the mitral and aortic valves. Logistic regression analysis showed that older age(OR=1.055), hyperphosphatemia(OR=8.234) were risk factors for CVC, higher SPP24(OR=0.997) was a protective factor. Older age(OR=1.086) and hyperphosphatemia(OR=7.393) were risk factors for calcification of the mitral and aortic valves, higher SPP24(OR=0.964) level was a protective factor. Patients were followed up, the follow-up intervals were from 2 to 14 months, and it was found that CVC(HR=4.156) increased the risk of cardiovascular events in hemodialysis patients, high SPP24 level(HR=0.976) reduced the risk of cardiovascular events. Calcification of the mitral and aortic valves increased the risk for cardiovascular events(HR=3.071). Conclusion The incidence of cardiac valve calcification in maintenance hemodialysis patients is as high as 53.41%. Older age and hyperphosphatemia are risk factors for CVC, while high SPP24 level is a protective factor for CVC. CVC is an independent risk factor for cardiovascular events, and high SPP24 level is a protective factor for cardiovascular events.