Objective To investigate the effect of Cinacalcet on the levels of serum calcium (Ca), serum phosphorus (P) and intact parathyroid hormone (iPTH) in patients with hyperparathyroidism secondary to hemodialysis, providing reference and basis for further improving the clinical treatment effect. Methods A total of 60 patients with hyperparathyroidism secondary to hemodialysis who were admitted to Nanjing Central Hospital from January 2016 to June 2021 were selected as the research subjects, according to the random number table method, they were divided into control group and observation group, there were 30 patients in each group. The control group were given routine symptomatic and supportive treatment such as Phosphorus binders and Vitamin D analogs, on the basis of the control group, the patients in the observation group were treated with Cinacalcet hydrochloride tablets, the two groups of patients were treated for 3 months. The clinical efficacy after treatment, blood urea nitrogen (BUN), serum creatinine (SCr), urea clearance index (KT/V), hemoglobin (Hb) level, parathyroid gland size, Ca, P, calcium-phosphorus product, iPTH level before and after treatment, the incidence of adverse reactions during the treatment period were compared and analyzed between the two groups. Results After treatment, the total effective rate of patients in the observation group were 96.67%, which was significantly higher than 73.33% of the control group; compared with before treatment, after treatment the levels of peripheral blood Hb in the two groups significantly increased, and the observation group was significantly higher than the control group; after treatment the length, width, thickness and volume of parathyroid glands in the two groups significantly reduced, and the observation group was significantly smaller than the control group; after treatment the levels of Ca, P, calcium-phosphorus product and iPTH in the two groups significantly decreased, and the observation group was significantly lower than the control group; during treatment, the total incidence of adverse reactions in the observation group were 13.33%, which was significantly lower than 40.00% of the control group (all P <0.05); there was no significant difference in the levels of BUN, SCr and KT/V between the two groups before and after treatment (allP >0.05). Conclusion Cinacalcet can effectively reduce the volume of parathyroid glands in patients with hyperparathyroidism secondary to hemodialysis, reduce the level of parathyroid hormone, regulate the serum Ca and P levels of patients, with significant effect, and security is good