Epicardial adipose tissue (EAT) is a cardiovascular risk predictor in general population. However, its value has not been well validated in maintainance hemodialysis (MHD) patients. We aimed to assess associations of EAT with cardiovascular risk predictors in nondiabetic MHD patients. In this cross-sectional study, we measured EAT thickness by transthoracic echocardiography in 50 MHD patients (45.8 +/- 14.6 years of age, 37 male). Antropometric measurements, bioimpedance analysis, left ventricular (LV) mass, carotis intima media thickness, blood tests, homeostasis model assessment for insulin resistance (HOMA-IR) and hemodialysis dose by single-pool urea clearence index (spKt/V) were determined. The mean EAT thickness was 3.28 +/- 1.04mm. There were significant associations of EAT with body mass index (=0.590, P<0.001), waist circumference (=0.572, P<0.001), body fat mass (=0.562, P<0.001), percentage of body fat mass (=0.408, P=0.003), percentage of lean tissue mass (=-0.421, P=0.002), LV mass (=0.426, P=0.002), carotis intima media thickness (=0.289, P=0.042), triglyceride/high-density lipoprotein cholesterol ratio (=0.529, P<0.001), 1/HOMA-IR (=-0.386, P=0.006), and spKt/V (=-0.311, P=0.028). No association was exhibited with visfatin C, high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha (for all, P>0.05). Body mass index, waist circumference, body fat mass, percentage of lean tissue mass, LV mass, triglyceride/high-density lipoprotein cholesterol ratio, HOMA-IR, and spKt/V appeared as independent predictors of EAT. EAT was significantly associated with body fat measures, cardiovascular risk predictors, and dialysis dose in MHD patients.