Introduction: In CKD patients, the leading cause of mortality is cardiovascular disease. In most cases, it is related to vascular calcification. Among multiple risk factors for vascular calcification, decline of residual renal function is an important one. So far, there is scarce information about the influence of residual renal function on vascular calcification in HD patients. Objective: To determine the association between vascular calcification and left ventricular hypertrophy in HD patients with low RRF. Methods: An observational study was performed on 60 CKD patients on MHD with low RRF attending in dialysis units of Chittagong Medical College Hospital in Bangladesh during the period from April 2018 to March 2019. Blood samples for biochemical analysis were collected in fasting condition. At the same day, lateral lumbar radiography and M mode echocardiography was done for vascular calcification score and LVH respectively. Results: The prevalence of vascular calcification was present in 88.3% cases in patients with low RRF. Patients without vascular calcification had normal LVMI in 100% cases and those with vascular calcification had increased LVMI in 75% cases, which was very highly significant. The duration of dialysis, age, gender and smoking were not statistically significant for vascular calcification. There was positive correlation of vascular calcification with FBS, CRP, iPTH, Cholesterol, BMI, Serum Calcium, Serum Phosphate, Ca x PO4 product and systolic BP but it was negative for Serum Albumin, Diastolic BP and 24 hours UTV. Conclusion: Vascular calcification is very common in patients with ESRD on MHD. Loss of RRF is an important risk factor for vascular calcification. Patients with vascular calcification had significantly raised LVMI.