Objective: To explore the relationship between serum retinol binding protein (RBP) and cardiovascular events in patients with end-stage renal disease on maintenance hemodialysis (MHD). Methods: The clinical data of 100 patients with end-stage renal disease who underwent MHD treatment in our hospital from March 2017 to March 2020 were retrospectively analyzed. General information and serum RBP levels within 24 hours after admission were collected. According to whether cardiovascular events occurred during the treatment, the patients were divided into an event group (n=41) and a non-event group (n=59). Univariate and logistic regression models were used to analyze the relationship between related indicators and cardiovascular events in patients with MHD end-stage renal disease. Receiver operating characteristic curve (ROC) was used to analyze the value of RBP in the evaluation of cardiovascular events in patients with MHD end-stage renal disease. Results: Compared with the non-event group, the event group had significantly older age, longer dialysis time, and significantly higher levels of triglyceride (TG), Troponin (cTnT), C-reactive protein (CRP), serum creatinine (sCr), immunoreactive parathyroid hormone (iPTH) and RBP (P<0.05). Logistic regression analysis showed that age (OR=1.369), dialysis time (OR=1.595), cTnT (OR=1.082), CRP (OR=1.059) and RBP (OR=2.793) were independent risk factors for cardiovascular events in MHD patients with ESRD (P<0.05). ROC curve analysis showed that the area under the curve of serum RBP level in predicting cardiovascular events in MHD patients with end-stage renal disease was 0.769 (95%CI: 0.662–0.855), sensitivity was 75.61%, specificity was 70.73%. Conclusion: High level of RBP is an independent risk factor for cardiovascular events in MHD patients with end-stage renal disease, which has important predictive value for cardiovascular events in MHD patients with end-stage renal disease.