Objective Ultrafast pulse wave velocity technique was used to evaluate the stiffness of carotid wall in renal failure with secondary hyperparathyroidism patients treated with maintenance hemodialysis.Methods A total of 30 patients with secondary hyperparathyroidism in chronic renal failure and receiving maintenance hemodialysis for 6-12 months were enrolled.The age and sex mached healthy cases were selected as control group(n=34). After conventional carotid ultrasound examination, ultrafast pulse wave velocity (ufPWV) was used to measure the pulse wave velocity of the begining-systole (PWV-BS) and the pulse wave velocity of the end-systole (PWV-ES), obtaining the stiffness of the carotid. Results Compared with the control group, PWV-BS and PWV-ES of MHD group were significantly increased, and the difference was statistically significant (P < 0.05). Conclusion Patients with secondary hyperparathyroidism in chronic renal failure undergoing maintenance hemodialysis, which is increased the stiffness of the carotid. The parameter PWV-ES is more sensitive than PWV-BS to reflect the change of vascular wall stiffness.