Objective To analyze the value of high sensitivity C-reactive protein (hs-CRP), neutrophil to lym-phocyte ratio (NLR), and fibroblast growth factor 23 (FGF23) in the evaluation of the prognosis of patients with chronic renal failure (CRF) treated with maintenance hemodialysis. Methods The clinical data of 202 patients with CRF admitted to the hospital from January 2017 to March 2018 who received maintenance hemodialysis were collected. In the prognosis, 151 cases survived (74.75%, survival group), and 51 cases died (25.25%, death group). At the same time, 150 healthy people who underwent physical examination were selected as the control group. The hs-CRP, NLR and FGF23 levels of the control group, study group and CRF hemodialysis patients with different prognosis were compared. The predictive value of the above-mentioned factor levels for the prognostic survival of patients undergoing CRF maintenance hemodialysis was analyzed.Results The levels of hs-CRP, NLR and FGF23 in the study group were significantly higher than those in the control group (P＜0.05). The levels of hs-CRP, NLR and FGF23 in the survival group were significantly lower than those in the death group (P＜0.05). According to logistic regression model analysis, cardiovascular disease, high load capacity, increased hs-CRP, NLR and FGF23 levels are risk factors that affect the prognosis death of patients undergoing CRF maintenance hemodialysis (P＜0.05).ROC curve analysis results showed that the area under the curve (AUC) of hs-CRP, NLR and FGF23 were 0.753, 0V717, and 808, respectively. The AUC of FGF23 was the largest, but the AUC of the three combined detection was higher, which was 0.843.Conclusion The abnormal expression of hs-CRP, NLR and FGF23 in patients with CRF maintenance hemodialysis may be closely related to the prognosis of ACS patients. The detection of the levels of these factors can help assess the prognosis of patients.