This study is to investigate the associations between apolipoprotein E (ApoE) gene polymorphisms and cardiovascular complications of uremic patients on maintenance hemodialysis (MHD). Uremic patients on MHD (189, case group) and healthy people (165, control group) were recruited. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to test ApoE gene polymorphisms. Indicators of MHD and cardiovascular complications were observed. Compared with the control group, the case group had decreased frequency of ε3/3 genotype and ε3 allele and increased ε4/3 genotype and ε4 allele. The ε4 group had elevated adiponectin, serum creatinine, blood urea nitrogen, and total cholesterol but decreased HDL-C compared with other groups. The ε3 group had reduced complications. ApoE ε3 and ε4 alleles were related with cardiovascular complications of the uremic patients on MHD. We concluded that ApoE gene polymorphisms were associated with susceptibility to infections in uremia, and that ApoE ε3 and ε4 alleles might correlate with cardiovascular complications of uremic patients on MHD.