【Abstract】 Objective To investigate the association between blood pressure variablility (BPV) with outcomes in hemodialysis patients.Methods In this retrospective study, we enrolled 265 patients on hemodialysis from July 1, 2014 to June 31, 2016 in Southeast University affiliated Zhongda Hospital. Blood pressure (BP) measurements were obtained before, every one hour in and after dialysis session to determine each patient’s BPV. The primary endpoint was cardiovascular and allcause mortality. And the associations between BPV and study outcomes were analyzed. Results The average BPV of SBP and DBP pre, in and posthemodialysis was 0115±0070, 0128±0114, 0120±0046, 0127±0084, 0099±0084, 0105±0029, respectively. A higher BPV of predialysis SBP was significantly associated with higher rates of cardiovascular and allcause mortality (P＜005). The result of a univariate Cox regression analysis showed that the BPV of predialysis SBP was an independent risk factor for cardiovascular and allcause mortality. And a mutivariate Cox regression model further indicated that the BPV of predialysis SBP was an independent risk factor for cardiovascular mortality. Conclusion In this study, we found that greater variability in predialysis SBP is an independent risk factor for cardiovascular mortality in hemodialysis patients. These results suggest that BPV of predialysis SBP might have prognostic value in patients with hemodialysis.