Abstract: Catheter-related atrial thrombus（CRAT） is a rare complication in hemodialysis patients，which includes mural thrombus and catheter tip thrombus. CRAT is closely associated with positioning of the catheter tip in the atrium. Repeated mechanical trauma to the atrial wall from catheter tip，the fluid dynamics within right atrium and systemic hypercoagulable state can promote thrombosis. Most of patients with CRAT are asymptomatic，some cases presented with catheter malfunction，cardiovascular abnormalities and other discomforts. However CRAT might bring serious adverse and sometimes fatal events when complications such as embolism and infection occurred. It is mainly diagnosed by cardiac imaging studies including transthoracic echocardiography（TTE），transesophageal echocardiography（TEE），computed tomography angiography（CTA），magnetic resonance imaging（MRI）. According to the size，location of thrombus，general condition of patients and available techniques in medical facilities，therapeutic strategies including catheter-directed therapy，surgical thrombectomy，anticoagulation，systemic thrombolysis，catheter removal and so on can be individually selected. This review summarized the epidemiology，classification，pathogenesis，clinical manifestations，diagnosis and treatments of CRAT in hemodialysis patients.

Key words: hemodialysis, catheter-related atrial thrombus, catheter-directed therapy