Objective To explore the effect of risk management on the risk of nursing defects during hemodialysis in maintenance hemodialysis (MHD) patients. Methods The risk management was carried out in our hemodialysis room 61 patients with MHD treated in our hospital from Jun. 2014 to Jun. 2015 were divided into risk management group, another 58 patients with MHD treated in our hospital were control group, and these 58 patients were only given routine nursing. The incidence of adverse events and comfort degree during hemodialysis were compared between the two groups, and the scores of nurses' operation skills and risk management in the two groups were observed. Results The incidence rate of adverse events in the risk management group was lower than that in the control group, the score of General Comfort Questionnaire (GCQ) in the risk management group was higher than that in the control group (P<0.05), and the scores of nurses' operation skills and risk management in the risk management group were also higher than those in the control group. Conclusion Risk management can not only reduce the incidence of adverse events, but also improve comfort degrees for patients in hemodialysis room, and enhance nurses' operation skills and risk awareness.