Objective To investigate the clinical value of eosinophilic percentage (EOS%), albumin (Alb)/C-reactive protein (CRP) and platelet/lymphocyte ratio (PLR) in predicting the prognosis of patients with maintenance hemodialysis (MHD). Methods 96 patients who received maintenance hemodialysis (MHD) treatment in our hospital from January to June 2023 were selected as the study objects. Patients were divided into death group (n=38) and survival group (n=58) according to follow-up 1 year after discharge. EOS%, PLR, Alb/CRP and laboratory indexes of the two groups were analyzed and compared. To analyze the related factors affecting the prognosis of MHD patients. Receiver operating characteristic (ROC) curve was drawn to analyze the application value of EOS%, PLR, Alb/CRP combined detection in predicting the prognosis of MHD. Results The EOS%, PLR and serum creatinine values in death group were significantly higher than those in survival group, and the Alb/CRP values were significantly lower than those in survival group (P < 0.05). There were no significant differences in triglyceride, white blood cell count, total cholesterol and hemoglobin between the two groups (P > 0.05). Logistic analysis showed that EOS%, PLR, serum creatinine and Alb/CRP were all risk factors affecting the prognosis of MHD patients (P < 0.05). The area under the curve (AUC) of EOS%, PLR, and Alb/CRP in predicting MHD prognosis were 0.886, 0.850, and 0.833, respectively. AUC of the combined detection was 0.945, sensitivity was 0.914, and specificity was 0.868, which were significantly higher than that of single detection. Conclusion EOS%, PLR and Alb/CRP are all effective prognostic indicators in MHD patients, and the combined detection of the three can improve the prediction accuracy.