Objective To investigate the occupational risk of nurses in nocturnal hemodialysis (NHD), and to analyze the relevant factors and coping approach to occupational risk. Methods The occupational risk of 25 nurses at conventional hemodialysis (CHD) and 25 nurses at NHD were investigated using Nursing Occupational Risk Assessment Questionnaire. The Likert Scale 5-grade method was used to score the questionnaire, to obtain occupational risk index, and to analyze the relevant risk factors. Results The scores in 3 dimensions, including accidental risk, chemical risk, and ergonomical, psychosocial and organizational risk, in the NHD nurse group were significantly higher than those in the CHD nurse group (P<0.05). The average risk index scores of the harzard of irregular working hours, interpersonal relation disturbance, frequent shift work, overtime, and night shift, and the hazard of understaffing and overworking were in the top 2 of each sub events, and they belonged to the risks which were order not allowed. Conclusion The average risk index of the nurses at NHD is higher than at CHD, and the formative factors are specific. Hospital managers should take active measures to prevent and reduce the occupational risk.