Objective To evaluate the effect of telmisartan on micro-inflammation and oxidative stress in maintenance hemodialysis (MHD) patients. Methods Sixty stable MHD patients and 30 healthy volunteers (control) were involved in this study. The MHD patients were randomly divided into telmisartan treatment group (group T; n=30) or non-telmisartan treatment group (group NT; n=30). Patients in group T took telmisartan at a dose of 80mg per day for 24 weeks. Plasma high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-a), lipid peroxide malondialdehyde (MDA), serum prealbumin (PA), and serum albumin (Alb) were measured before telmisartan treatment and after the treatment for 24 weeks. Results When comparisons were performed between MHD patients and healthy controls, plasma levels of hs-CRP (8.1±2.6 vs. 1.5±0.7mg/L), IL-6 (349.0±52.4 vs. 53.6±15.0ng/L), TNF-a (8.1±2.12 vs. 2.1±0.8ng/L) and MDA (7.3±3.2 vs. 3.5±0.9μmol/L) were significantly higher in MHD patients, and serum PA (20.6±7.3 vs. 28.4±4.0mg/dL) was significantly lower in MHD patients than in healthy controls (P＜0.05, respectively). When comparisons were conducted between group T and group NT, plasma levels of hs-CRP (5.6±1.8 vs. 8.2±2.8mg/L), IL-6 (218.6±45.9 vs. 363.0±67.4ng/L), TNF-a (5.3±1.7 vs. 8.7±2.3ng/L) and MDA (4.6±2.3 vs. 7.5±3.7μmol/L) were significantly lower, and serum PA (25.3±6.7 vs. 20.0±7.7mg/dL) was significantly higher in group T after telmisartan treatment for 24 weeks than in group NT (P＜0.05, respectively). Conclusion Telmisartan improves micro-inflammation, oxidative stress and malnutrition in MHD patients.