Patients with chronic kidney disease (CKD) have a high risk of cardiovascular morbidity and mortality. Vascular calcification (VC) is the most important cause of cardiovascular morbidity and mortality both in the general population and CKD. VC is mainly associated with mineral metabolism and chronic inflammatory disorders. Malnutrition, hyperphosphatemia, and hypercalcemia, as well as various calcification inhibitors and activators, play a role in the pathogenesis of VC. Activators and inhibitors involved in this pathogenesis regulate this process with mutually complex mechanisms, and new therapeutic strategies are being tested in this direction.