Purpose: We aimed to analyze the incidence rate and risk factors of vasoplegic syndrome (VPS) after cardiac surgery in patients undergoing chronic hemodialysis (HD). Methods: This retrospective, single-center cohort study included 106 HD-dependent patients who underwent cardiac surgery between April 1, 2013, and January 31, 2020. We retrospectively analyzed the incidence rate and independent risk factors of VPS in a multivariate analysis of the four factors reported in previous literature: diabetes, ejection fraction (EF) <40%, dialysis history, and oral beta-blocker usage. Results: Of the original 106 patients, five patients were excluded because of insufficient data, and 39 patients (38.6%) developed VPS. Having an EF of <40% was identified as an independent predictor of VPS. Conclusions: The incidence of VPS in patients on dialysis was 38.6%. Our results suggest that having an EF of <40% is an independent risk factor for developing VPS in HD-dependent patients. Perioperative management during cardiac surgery in such patients, especially those with reduced cardiac function, should be performed with caution, keeping the risk of VPS in mind.