Background and aims: Hemodialysis (HD) patients belong to the group of patients with a high prevalence of cardiovascular disease. Atherosclerosis is the most frequent cause of cardiovascular morbidity in patients with end-stage renal disease (ESRD).There is a high prevalence of vascular calcification among ESRD patients on hemodialysis and this is correlated to the presence of preexisting cardiovascular disease. The aim of the present study was to test the correlation between various calcification scores and cardiovascular morbidity in patients with end stage renal disease on dialysis. Subjects and methods: 91 ESRD patients on regular hemodialysis at Kasr ElAini Hemodialysis Unit and Kasr ElAini Nephro-Urology Unit (King Fahd Unit) were recruited to participate in the study in observational period 18 months. The included patients were 44 males and 47 females . Patients below age 18 years and pregnant women were excluded. All subjects incorporated in the study were evaluated thoroughly by history taking, clinical examination and routine laboratory investigations for hemodialysis patients.Vascular calcification was assessed by non-contrast CT abdomen ,lateral lumbar x ray and x rays of both hands and pelvis. Results: We found a high prevalence of vascular calcification using six different radiological scores among ESRD patients on hemodialysis which increased progressively from proximal to distal along the abdominal aorta. This prevalence was higher in our study when measured by CT compared to plain X rays.Frequency distribution of vascular calcification by CT thorax score was 24.3% , CT suprarenal score was 33.7% , CT infrarenal score was 47.2% , CT bifurcation score was 42.3%, Kauppila score was 24.4% , and by Adraogo score was 34.1%.We also found a positive correlation between calcification scores and diabetes mellitus , age and other factors correlating to the presence of vascular calcification including phosphate level, triglycerides, parathyroid hormone and dialysis adequacy as measured by kt/v urea. We also found that cardiovascular disease in our study population was correlated in logistic regression analysis with age (P value = 0.001) and BMI (P value = 0.02) and negatively correlated with Kt/v urea (P value =0.006). We also found that vascular calcification scores were also correlated positively with the presence of cardiovascular disease. Conclusions: There is a high prevalence of vascular calcification among hemodialysis patients and this is more readily predicted by CT based technique .This vascular calcification correlated positively with the presence of pre-existing cardiovascular disease.