Objective To analyze the predictive value of serum microtubule-associated protein 1 light chain 3-II (LC3-II) combined with microinflammation index on the prognosis of maintenance hemodialysis patients. Methods 92 patients who underwent maintenance hemodialysis treatment in our hospital from January 2020 to January 2022 were selected as the research subjects of this study. After treatment, they were followed up for 1 year. According to the follow-up results, they were divided into a survival group of 77 cases and a death group of 15 cases. Observed the general information of each group and used ELISA to detect LC3-II Hs CRP, SAA, IL-6 levels. ROC curve was used to analyzed the predictive value of serum LC3-II combined with micro inflammatory markers for the prognosis of maintenance hemodialysis patients. Results The incidence of malnutrition, serum potassium, creatinine and urea nitrogen levels in the deceased patients were higher than those in the surviving patients, and the filtration rate of residual kidney was lower than that in the surviving patients (P＜0.05). Compared with the survival group, the levels of LC3-II in the death group were lower, and the levels of hs-CRP, SAA and IL-6 were higher (P＜0.05). Multi-factor logistic regression analysis showed that malnutrition, residual kidney filtration rate, blood potassium, creatinine, urea nitrogen, LC3-II, hs-CRP, SAA and IL-6 were the risk factors affecting the prognosis of patients (P＜0.05). ROC curve displayed, the combined detection of LC3-II, hs-CRP, SAA, and IL-6 had a higher predictive value for the prognosis of maintenance hemodialysis patients (P＜0.05). Conclusion The prognosis of maintenance hemodialysis patients is related to many factors, and the expression level of LC3-II in dead patients is low, while the expression levels of hs-CRP, SAA and IL-6 are high. Detection of LC3-II, hs-CRP, SAA and IL-6 can be used to predict the prognosis of maintenance hemodialysis patients