Objectives: This study aims to analyze low-density lipoprotein (LDL) levels and the relationship with death to identify the appropriate lipid profile in Korean older hemodialysis (HD) patients. Methods: A total of 2,468 incident hemodialysis patients aged >70 years were enrolled from a retrospective cohort from the Korean Society of Geriatric Nephrology including 17 academic hospitals in South Korea. Multivariate Cox regression analysis was used to select risk factors from 20 clinical variables between the LDL groups. Results: Out of 2468, 1387 (56.1%) participants were classified as statin-naive. Crude mortality was 73.4% in the 1st quartile (Q1), 2nd quartile (Q2): 69.8%, 3rd quartile (Q3): 69.3% and 4th quartile (Q4): 64.2%, according to LDL quartile group (p=0.307). The multivariate Cox regression analysis, including all participants, showed that low LDL level was associated with all-cause mortality, compared with the 1st lowest quartile in the final model- Q2: hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.5090.870, p=0.003; Q3: HR 0.77, 95% CI 0.5991.001, p=0.05; Q4: HR 0.63, 95% CI 0.4900.828, p=0.001) after adjustment for covariates such as sex, body mass index, serum albumin, concurrent history of hypertension, diabetes mellitus, congestive heart failure, and cardiovascular disease (p = 0.004). According to final model, all-cause mortality increased as LDL-C levels decreased, confirming a restrictive cubic spline plotting. Conclusions: In older HD patients who had not previously taken dyslipidemia treatment, elevated LDL levels were not associated with the increase in all-cause mortality.