Objective: To compare the clinical curative effect of continuous renal replacement therapy (CRRT) and hemofiltration + hemoperfusion on metabolic encephalopathy in patients with uremia. Methods: According to random number table method, 64 patients with uremia and metabolic encephalopathy who were admitted to the hospital were divided into control group (CRRT) and observation group (hemofiltration + hemoperfusion) between January 2023 and December 2024, 32 cases in each group. The nerve function [National Institutes of Health Stroke Scale (NIHSS)], Glasgow Coma Scale (GCS), biochemical indexes [blood urea nitrogen (BUN), serum creatinine (SCr), concentration of blood potassium and sodium] and coagulation function indexes [prothrombin time (PT), activated partial thromboplastin time (APTT)], fibrinogen (FIB)] in the two groups were compared before and after treatment. Results: After treatment, NIHSS score, BUN, SCr, concentration of blood potassium and sodium, PT, APPT and FIB in observation group were lower than those in control group, and GCS score was higher than that in control group (P<0.05). Conclusion: Compared with CRRT, hemofiltration + hemoperfusion has advantages such as improving nerve function and regulating biochemical indexes in patients with uremia and metabolic encephalopathy, which has higher treatment safety.