Abstract: Objective To investigate the clinical application value of parathyroid hormone levels in uremic hemodialysis patients with parathyroid 99Tcm-MIBI SPECT/CT fusion imaging. Methods The serum parathyroid hormone levels in 63 uremic patients before hemodialysis were measured, and then all patients accepted parathyroid 99Tcm-MIBI SPECT/CT planar imaging at 10 min and 120 min post-injection, additional tomography and CT scan fusion imaging at 120 min post-injection. The relevance between the parathyroid hormone serum levels and SPECT/CT imaging results was analyzed. Results The early planar imaging showed the thyroid images, and the delay planar imaging showed a positive rate of 61.90% (39/63). The positive rate of tomography and fusion imaging was 66.67% (42/63). The mean levels of serum parathyroid hormone (PTH) in 42 parathyroid imaging positive patients were 1509.91± 614.25 ng/mL. The mean levels of serum parathyroid hormone in 19 patients confirmed by surgery operation and the other 23 patients were 1423.37±520.49 ng/mL and 1538.61±572.93 ng/mL respectively. There was no statistically significant difference between them (P>0.05). The mean serum PTH levels in 21 negative imaging patients was 944.21±721.43 ng/mL, there was a statistically significant difference compared with the 42 positive imaging patients (P<0.01). Conclusion The suspicious uremic hemodialysis patient based on the parathyroid hormone serum levels adapted to parathyroid 99Tcm-MIBI SPECT/CT could improve the examination positive rate and locate the lesions for surgery. The 99Tcm-MIBI SPECT/CT fusion imaging has more diagnostic value compared with the route planar and tomography imaging.