Abstract: Objective To investigate the effect of marital quality on the level of depression in maintenance hemodialysis patients in order to provide a reference for clinical nursing managers to take interventions to reduce the level of depression in hemodialysis patients. Methods A total of 176 hemodialysis patients were recruited from the Second Affiliated Hospital of Wenzhou Medical University, between February, 2016 and February, 2017. They were investigated with the general information questionnaire, marriage perception scale and Chinese version of the Beck depression inventory-Ⅱ. Statistical analysis was conducted using univariate analysis, Pearson correlation analysis to understand the status of the patient's marriage quality and depression level, and to explore the relationship between the two. Results The total score of depression in maintenance hemodialysis patients was (25.88±5.94) points, and the total score of marriage quality was (50.18±12.86) points. Single factor analysis showed that the literacy, duration, and marital quality were the influencing factors of depression in maintenance hemodialysis patients. The quality of marriage in patients with maintenance hemodialysis was negatively correlated with their depression level (r=-0.362, P<0.001). Conclusion Depression is a common psychological disease in maintenance hemodialysis patients. This study shows that the quality of marriage can predict the depression level of maintenance hemodialysis patients, and improving the marital quality of maintenance hemodialysis patients will help improve the depression level of patients.