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Background: Cardiovascular disease is the most common cause of death in patients with chronic kidney disease. Diastolic dysfunction is an important risk factor result in development of advanced cardiovascular disease. Fibroblast growth factor- 23 (FGF23) secretes in response to hypophosphatemia as a result of renal excretion of phosphate. Elevation of serum FGF23 is one of the possible causes of diastolic dysfunction. The aim of the current study was to investigate association between Serum levels of FGF23 and diastolic dysfunction in hemo dialysis patients. Methods: 100 hemodialysis patients were enrolled in the study between October 2015 and February 2016. Cardiac diastolic function was assessed by tissue Doppler imaging and ejection fraction>50% considered to be investigated. Serum FGF23, cholesterol, triglyceride, fasting blood sugar, 25(OH)vitD3, Phosphorus, calcium, alkaline phosphatase, PTH and hemoglobin were measured in all patients. Statistical analysis preformed using SPSS version 16(Chicago, USA). Results: FGF 23 was elevated in 69% (52/75) of patient and had correlation with serum levels of phosphor and PTH, while Serum levels of FGF23 was not significantly difference between patients whit diastolic dysfunction versus other cardiac problem (p=0.158). Conclusions: After elimination of secondary causes of diastolic dysfunction, no association was found between serum FGF23 levels and diastolic dysfunction among hemodialysis patients.