Objective To investigate the prevalence of hyperphosphatemia in adult patients with chronic kidney disease (CKD) in the United States, and to analyze the association between clinical features of CKD patients and hyperphosphatemia. Methods Based on the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018, the prevalence of hyperphosphatemia in adult patients with CKD stratified by survey years and CKD stages was statistically described. Multivariate logistic regression was used to analyze the association between clinical features of CKD patients and hyperphosphatemia. Results Totally 9 311 adult patients with CKD staged 1-5 were included. The weighted prevalence of hyperphosphatemia was 9.8%. From 1999 to 2004, the weighted prevalence of hyperphosphatemia showed an increasing trend over time, and remained relatively stable from then on to 2012. The weighted prevalence was the highest from 2013 to 2014, and then gradually decreased over time. The weighted prevalence of hyperphosphatemia increased with the progression of CKD stages, which were 7.99%, 8.64%, 11.90%, 21.57%, and 54.66% in the patients with CKD stages 1-2, 3a, 3b, 4, and 5, respectively. Men (odds ratio[OR]=0.53), the elder (OR=0.67 for those 65-74 years old and 0.53 for ≥ 75 years old), and patients with obesity (body mass index ≥ 30 kg/m², OR=0.79) tended to have a lower prevalence of hyperphosphatemia (all P<0.05). Conclusion The prevalence of hyperphosphatemia in CKD patients is increased at the early stage of renal impairment (i.e., CKD 3a). Male, elderly and obese CKD patients tend to have a lower prevalence of hyperphosphatemia.