Background: Pulmonary artery hypertension (PAH) is linked with morbidity and mortality in hemodialysis (HD) patients. The relationship between serum parathyroid hormone (PTH) and PAH is still a subject of debate. Objectives: The goal of the present study was to assess the association between PTH and PAH among HD patients. Methods: This was a cross-sectional study that assessed HD patients in a tertiary hospital in Mashhad, Iran. Echocardiography was performed for all patients to measure pulmonary artery pressure (PAP) and ejection fraction. Laboratory data, including serum calcium, phosphorus, vitamin D, serum albumin, and alkaline phosphatase, were extracted from patient documents. The statistical tests included independent t-test, Mann-Whitney, chi-squared test, and logistic regression. Results: A total of 78 patients (43 males and 35 females) participated in this study. The mean age was 37.25 ± 11.98 years old. There was a significant difference in the PAH distribution pattern between hyperparathyroidism and normal PTH groups (P = 0.003). PAH was significantly related to hyperparathyroidism (P = 0.004, OR = 4.557), age (P = 0.033, OR = 0.944), and calcium level (P = 0.005, OR = 0.336). After adjusting for other variables, the odds ratio for the relationship between PAH and hyperparathyroidism increased to 7.593. Conclusions: The findings of this study supported the possible link between hyperparathyroidism, serum calcium level, and PAH in HD patients.