Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis (MHD) patients and possible mechanism. Methods A total of 40 MHD patients [mean age (53.5±7.1) years] who underwent normal hemodialysis more than 6 months were randomly classified into two groups, Levocarnitine supplemented group (LS-G) (n=20; Levocarnitine supplementation after each normal hemodialysis session, at a dose of 1.0 g/day by intravenous administration) and control group (C-G) (n=20; normal hemodialysis). Before treatment, one month and three months after treatment we respectively measured or observed the following items, the tolerance to hemodialysis, carnitine level in plasma, C-reactive protein, IL-6, TNF-α, percentage of neutrophil, and some relevant nutritional parameters, such as lipid profile, transferrin, total protein, albumin and prealbumin levels. Comparative analysis was conducted between the two groups. Results In LS-G three months after treatment, the levels of carnitine, hemoglobin, and prealbumin in plasma were significantly increased (P