Objective To understand the current level of social alienation in maintenance hemodialysis patients, explore its influencing factors, and provide reference for medical staff to formulate nursing strategies. Methods A survey was conducted on 310 maintenance hemodialysis patients using a general information questionnaire and the General Sense of Alienation Scale. Results The social alienation score among maintenance hemodialysis patients was (44.75 ± 5.62). Multiple linear regression analysis showed that age, education level, marital status, employment status, family residence, course of disease, frequency of disease recurrence, duration of hemodialysis, frequency of hemodialysis, chronic comorbidities, and whether having deep knowledge of hemodialysis were the influencing factors for social alienation (all P.<0.05). Conclusion The degree of social alienation in maintenance hemodialysis patients is relatively severe. Medical staff can develop targeted intervention strategies based on influencing factors to reduce the degree of social alienation in maintenance hemodialysis patients and promote their return to society.