Introduction: Lipoprotein (a) [Lp(a)] is considered as a risk factor for coronary atherosclerotic disorder and an increase in plasma Lp(a) concentration is usually seen in patients with kidney failure.Objectives: We aimed in this study to evaluate the impact of plasma Lp(a) level on early changes of atherosclerotic vessels in stable hemodialysis (HD) patients.Patients and Methods: In this clinical study 61 patients (50 non-diabetic (F=20 M=30) and 11 diabetic HD patients), receiving maintenance hemodialysis were included and serum Lp(a) was measured. B-mode ultrasonography of carotid intima-media thickness (cIMT) was also determined.Results: The mean ±SD of patients Lp(a) was 58.5±19 mg/dL. The mean ±SD of diabetic patients’ Lp(a) was 62±12mg/dL and for nondiabetic ones was 57.7± 20mg/dL. In this study the thickening of Intima-media complex in diabetic group was more than non-diabetics, and no significant difference was found of Lp(a) between diabetic and non diabetic HD patients. There was a significant positive association between serum Lp(a) and cIMT.Conclusion: Accelerated atherosclerosis seen in diabetic hemodialysis patients. Lp(a) might have an important role in progression of atherosclerosis to accelerate progressive atherosclerosis in these patients.