The research assessed calcium (Ca) and phosphorus (P) metabolism and microinflammation in malnourished uremic patients, focusing on the severity of vascular calcification, and examined the relationship between Ca and P metabolism indicators and microinflammation and the severity of vascular calcification. Seventy-eight patients undergoing hemodialysis treatment for >= 6 mo were collected. General information and anthropometric and blood biochemical indices were recorded, including gender, age, body mass index, mid-arm muscle circumference, albumin, intact parathyroid hormone, and Ca and P product (CaXP). The severity of vascular calcification was graded. The correlation between the severity of vascular calcification in patients and each of the clinical indicators was analyzed. The diagnostic value of Ca and P metabolism and microinflammatory factors for vascular calcification in malnourished uremic patients was assessed. All enrolled patients were divided into a non-vascular calcification group (n=42) and a vascular calcification group (n=36) according to coronary artery calcification (CAC) scoring, and the probability of vascular calcification was 46%. The dialysis duration, CaXP, P, hypersensitive C-reactive protein (hs-CRP), and interleukin 6 (IL-6) levels were significantly higher in the vascular calcification group than in the non-vascular calcification group. hs-CRP, IL-6, CaXP, and P had predictive potency for vascular calcification in patients. CAC scores were correlated positively with hs-CRP, IL-6, CaXP, and P. Malnourished uremic patients have a higher incidence of vascular calcification. hs-CRP, IL-6, CaXP, and P are all independent risk factors for vascular calcification in uremic patients, and are positively correlated with the severity of vascular calcification.