【Abstract】 Objective To investigate the relationship between blood pressure variability (BPV) and cognition in hemodialysis patients. Methods Between Dec 2012 and Dec 2014, 92 patients underwent maintenance hemodialysis were included in the study. Blood pressure was measured at each visit. Visittovisit BPV was quantified by calculating the standard deviation (SD). We applied the Montreal Cognitive Assessment (MoCA) to test the cognitive function and calculate scores. The patients were divided into the patients with impaired cognition and the patients with normal cognition. Differences of laboratory data and BPV were studied in the two groups of patients. Results Significant difference were found in age, duration of dialysis, platelets count, SD of predialysis SBP, and SD of predialysis DBP（P<0.05）. Multiple linear regression analysis showed that age（P=0.037）and SD of predialysis SBP（P=0.023）were correlated to cognitive impairment. Conclusion Cognition impairment was a common phenomenon in hemodialysis patients. Older age and high predialysis SBP variability were accompanied with worse cognitive function.