Abstract: Objective To report a case of shrinking men syndrome（SMS） accompanying physiognomy change caused by renal osteodystrophy in a female patient with uremia undergoing dialysis and to analyze its pathogenesis. Methods Clinical and imaging data about the patient were analyzed.Clinical characteristics of SMS as well as its prevention and treatment were studied by reviewing the related literature. Results The iPTH of the patient increased to 2 208pg/L one year after regular renal dialysis.She was treated with 2.0μg Rocaltrol,twice a week for 4 weeks.Malformation of her face and articulations of both hands occurred and exacerbated accompanying left spinal bending,severe bone pain,and skin itching 2 years later.Spontaneous left femoral fracture occurred 6 years later.Her body height was 8cm shorter after dialysis.After high-volume blood dialysis,subtotal parathyroidec-tomy,correction of Ca and P metabolic disturbance,her bone pain and skin itching were significantly relived with her iPTH decreased to 160pg/L. Conclusion The quality of life in patients with SMS can be improved by early intervention of calcium and phosphorus metabolism,rational supplement of active VitD3,control of parathyroid hormone at the target range,and reduction of severe renal osteodystrophy incidence.