Objective To investigate the current status of cognitive function and frailty in maintenance hemodialysis patients, and to explore the relationship between cognitive impairment and frailty. Methods A cross-sectional survey was conducted on 467 maintenance hemodialysis patients from 3 hospitals in Lianyungang City by convenience sampling. The survey instruments included general data questionnaire, the Mini-Mental State Examination, and the Fried frailty phenotype assessment components. Results The prevalence of cognitive impairment and frailty was 28.7%, 35.5% respectively in maintenance hemodialysis patients. Logistic regression analysis showed that low grip strength and slowed gait in frailty phenotype were the main influencing factors of cognitive impairment (P<0.05, P<0.01). Conclusion Maintenance hemodialysis patients are prone to have impaired cognitive function and high prevalence of frailty. Frailty is a risk factor for cognitive impairment. For patients with decreased grip strength and gait speed, attention should be paid to the assessment of their cognitive function, so as to achieve early identification for targeted intervention.