Objective To investigate the effect of L-carnitine on insulin resistance in patients undergoing hemodialysis.Methods Forty patients undergoing hemodialysis were randomly divided into 2 groups. The therapy group were intravenously infused 1.0g of L-carnitine after every dialysis session; Control group were intravenously given 5ml saline. The reverse of fasting plasma glucose and insulin concentration product were used as index of insulin resistance. We observed for 12 weeks. Results In therapy group,the index of insulin resistance was significantly increased (P < 0.05) while No significant change was found in control group. Conclusion There is the presence of IR in patients undergoing hemodialysis; L-carnitine may improve the insulin resistance of hemodialysis patients.