<p>Lower serum parathyroid hormone (PTH) levels are reported to improve mortality and fracture incidence in patients using calcimimetics. We investigated the prognosis of calcimimetic users and non-users with similar PTH levels within the target range. This retrospective study compared 2-year all-cause mortality and the incidence of any fracture in dialysis patients between calcimimetic users (<i>n</i> = 131) and non-users (<i>n</i> = 294) with PTH levels between 60 and 240 pg/mL using a propensity score-matched model. Kaplan–Meier survival curves censored by PTH level, calcimimetic use, and other factors were compared; then, adjusted Cox proportional hazards regression analysis was performed. After matching, mortality was significantly lower in calcimimetic users than in non-users (<i>n</i> = 130; hazard ratio [HR] 0.243, 95% confidence interval [CI] 0.073–0.801, <i>P</i> = 0.022, log-rank test). The PTH levels of users and non-users were 142.4 ± 49.4 and 132.7 ± 48.0 pg/mL, respectively (<i>P</i> = 0.127). Cox regression analysis demonstrated that mortality was significantly lower in users than in non-users (adjusted HR 0.260, 95% CI 0.071–0.947, <i>P</i> = 0.041). Calcimimetic use had no effect on fracture incidence. These findings suggest that, among dialysis patients with PTH levels between 60 and 240 pg/mL, mortality risk was significantly lower among calcimimetic users than in non-users. However, fracture risk was not significantly different between these groups.</p>