Objective: Galectin-3 is a recently developed biomarker associated with fibrosis and inflammation, and it may play a role in cardiac remodeling in heart failure. However the clinical significance of this biomarkers is less determined in end-stage renal disease (ESRD) patients. This study was to evaluate the association of predialysis serum galectin-3 levels with echocardiographic markers in ESRD patients. Method: Serum Galectin-3 albumin, CRP, iPTH levels were obtained from predialysis blood samples of 112 incidental dialysis patients. Echocardiographic parameters included left ventricular mass index (LVMI) and ejection fraction, ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/e’ ratio), ratio of peak early transmitral flow velocity to peak late transmitral flow velocity (E/A ratio), and mitral valve-deceleration time (DT). Results: A direct correlation was found between galectin-3 and E/e’ ratio (r=0.209, p=0.028. A negative correlation was found between galectin-3 and Left ventricular ejection fraction (r=-0.198, p=0.036). In the multivariate linear regression analysis, the galectin-3 was independently positive associated with E/e’. Conclusions: Serum galectin-3 level is associated with diastolic dysfunction in incidental dialysis patient.