Chronic Renal failure patients on dialysis are at a high risk of death due to vascular calci cation (VC).This study aimed at investigating the effect of omega3-fatty acids on the vascular calci cation biomarkers fetuin-A and Osteoprotegerin (OPG) in patients with chronic renal failure (CRF) who are undergoing hemodialysis. This prospective, open-label, controlled, parallel study included 60 hemodialysis patients who were randomized to receive either omega-3 fatty acids capsule along with their standard care of treatment (omega-3 group) or their standard care of treatment only (control group).Serum levels of fetuin-A, OPG, calcium, phosphorus, hemoglobin, parathyroid hormone (PTH), blood urea nitrogen (BUN), albumin (ALB), serum creatinine (SCr), and serum triglycerides (TG) were measured at baseline and after six months of intervention and follow-up of both groups. Signi cantly increased levels of fetuin-A and OPG (p<0.001) were observed in the omega-3 group six months after the intervention compared with the control group. Levels of calcium, phosphorous, hemoglobin, parathyroid hormone, BUN, albumin, SCr, and TG were not signi cantly changed in the omega-3 group or the control group after six months of intervention. Our study concluded that omega-3 may have a clinically bene cial effect in decreasing cardiovascular events by increasing the levels of the protective vascular calci cation inhibitors fetuin-A and osteoprotegerin in chronic renal failure patients who are undergoing hemodialysis.