Cerebral blood flow (CBF) can be significantly reduced during a single hemodialysis session. However, few studies have investigated the effect of long-term hemodialysis on CBF and its correlation with neuropsychological tests. This study used pulsed arterial spin labeling to show that hemodialysis patients had significantly increased CBF in some cerebral regions. Increased CBF of the right opercular and triangular part of inferior frontal gyrus was negatively correlated with Mini Mental State Examination (MMSE) scores, and after adjusting for hemoglobin and hematocrit levels, these correlations became stronger. Dialysis duration, hemoglobin, hematocrit, and serum phosphorus were clinical risk factors for increased CBF.