Objective To investigate the serum level of sclerostin in the patients with peritoneal dialysis, and analyze the relevant factors. Methods Seventy-eight patients, who received peritoneal dialysis for more than 3 months in the First Affiliated Hospital, Medical School of Shihezi University and the Second Hospital of Sanming from January 2016 to January 2017, were selected as the experimental group; and 78 healthy people having physical examination in the same hospitals during the same period were selected as the control group. All the subjects received abdominal plain film examination. The 78 patients who received peritoneal dialysis were divided into a mild calcification group, a moderate calcification group and a severe calcification group according to abdominal aortic calcification score (AACS). The relevant biochemical indicators were collected, and the serum levels of sclerostin, fibroblast growth factor-23 (FGF-23) and 25-hydroxyvitamin D [25(OH)D] were examined with ELISA. The correlation between the degree of calcification and sclerostin protein level in the experimental group were analyzed. Results Compared with the control group, the serum levels of sclerostin and FGF-23 were significantly increased, but the serum 25(OH)D level was significantly decreased in the experimental group (P < 0.05). With the increase of the AACS, the levels of sclerostin protein, FGF-23, immunoreactive parathyroid hormone (iPTH), blood phosphorus, serum creatinine (SCr), uric acid, systolic blood pressure (SBP) and diastolic blood pressure increased significantly (P < 0.05), but level of 25(OH)D, blood calcium and eGFR decreased significantly (P < 0.05). Pearson linear correlation analysis showed that the sclerostin protein in the patients with peritoneal dialysis was positively correlated with age, blood phosphorus, iPTH, FGF-23, AACS, SCr and SBP (P < 0.05); but negatively correlated with 25(OH)D, blood calcium and eGFR (P < 0.05). Multiple linear stepwise regression analysis revealed that AACS, iPTH, FGF-23, 25(OH)D, eGFR, and blood phosphorus were the independent determinants of sclerostin protein level (P < 0.05). Conclusions Serum sclerostin protein level may increase in patients with peritoneal dialysis. It has certain correlations with AACS, iPTH, FGF-23, 25(OH)D, eGFR, and blood phosphorus.