Objective To explore the effect of aerobic combined with resistance exercise on elderly maintenance hemodialysis (MHD) patients with sarcopenic obesity, so as to provide a reference for developing effective exercise intervention measures. Methods Convenience sampling method was adopted to select 60 MHD patients with sarcopenic obesity, then they were randomized into an intervention group and a control group, with 30 cases in each group.The control group received routine nursing, while the intervention group additionally conducted aerobic combined with resistance exercise of upper limb elastic ball, lower limb elastic band and aerial bicycle.After the intervention for 12 weeks, important muscles, obesity, laboratory indexes and the Kidney Disease Questionnaire (KDQ) score were compared between the two groups. Results A total of 29 patients in the intervention group and 30 patients in the control group completed the study.After 6 weeks of the intervention, the area of visceral fat （VFA） in the intervention group was significantly lower than that in the control group; after 12 weeks, the grip strength, serum albumin and KDQ score in the intervention group were significantly higher than those in the control group, and its body fat percentage and VFA were significantly lower than those in the control group （all P＜0.05）. Conclusion Aerobic combined with resistance exercise can effectively improve the muscle strength and nutritional status of elderly MHD patients with sarcopenic obesity, and improve their quality of life.