The cardiovascular complication caused by long-term hemodialysis for end-stage renal disease, especially due to diabetic nephropathy is well known. This review is focusing on the histopathology of peripheral arteries among autopsied patients underwent hemodialysis during several years. The well-known term of “Moencheberg Medial Calcification” has been considered as a representative vascular lesion of patients with hemodialysis. However, vascular calcification in hemodialysis patients usually occurs in intima and media, classified as atherosclerosis Type V lesion of the classification by the American Heart Association.