MgO ceramics with the purity higher than 99.99% have been fabricated by a hot-isostatic press (HIP) technique of hot-pressed MgO compacts using nanometer MgO powder with an average particle size of 300 nm. The densification and grain growth behavior of MgO compacts during HIP process were investigated. The results indicate that the high-purity MgO ceramic with an average grain size of 9.76 μm and a density approximately to the theoretical density can be obtained by HIP method at 1350°C and 150 MPa for 60 min. HIP can significantly enhance the densification process of MgO compacts and cause a slightly change of grain size distribution.