Abstract：Objective：To observe the clinical effect of retention enema with Yishen Xiezhuo Decoction as an adjuvant treatment for chronic renal failure (CRF) undergoing maintenance hemodialysis (MHD) complicated with hyperphosphatemia. Methods：A total of 88 cases of patients with CRF undergoing MHD complicated with hyperphosphatemia were divided into the observation group and the control group by random number table method， with 44 cases in each group. The control group was treated with Calcium Carbonate and Vitamin D3 Tablets combined with a diet color chart， and the observation group was additionally treated with retention enema with Yishen Xiezhuo Decoction on the basis of the control group. Traditional Chinese medicine (TCM) syndrome scores，Kidney Disease Quality of Life Short Form (KDQOLSFTM1.3) scores， as well as levels of blood phosphorus (P)， calcium phosphorus (Ca-P) product， parathyroid hormone (iPTH)， and renal function indicators [creatinine (SCr) and urea nitrogen (BUN)] were compared before and after treatment between two groups. Clinical effects，incidence of adverse reactions and incidence of disease recurrence were evaluated in both groups. Results： After treatment， the total effective rate was 93.18% in the observation group，higher than that of 75.00% in the control group (P＜ 0.05). After treatment， TCM syndrome scores， blood P， Ca-P product， iPTH， and the levels of serum SCr and BUN in the two groups were decreased when compared with those before treatment (P＜0.05)； KDQOL-SFTM1.3 scores were increased， and TCM syndrome scores， blood P， Ca-P product， iPTH， and the levels of serum SCr and BUN in the observation group were lower than those in the control group， with KDQOL-SFTM1.3 score in the observation group was higher than that in the control group (P＜0.05). No serious adverse reations were observed in the two groups. After three months of follow-up，there was no significant difference being found in the recurrence rates between the two groups (P＞0.05). Conclusion： Retention enema with Yishen Xiezhuo Decoction as an adjuvant treatment for CRF undergoing MHD complicated with hyperphosphatemia has a definite curative effect，which can effectively promote patients' blood P metabolism，improve renal function，and enhance quality of life.