Objective To observe the effects of L-carnitine (L-CN) supplement on micro-inflammation and renal anemia in maintenance hemodialysis (MHD) patients. Methods Forty MHD patients who met the study criteria were randomly divided into treatment group and control group. In treatment group (n=20), patients were intravenously given L-CN 1g in 20ml normal saline through internal fistula before the end of a dialysis session, 3 times/week for 12 weeks; in control group, the injection was 20ml normal saline without L-CN. Serum C-reactive protein (CRP), interleukin-6 (IL-6), hemoglobin (Hb) and hematocrit (Hct) were measured before and after the L-CN therapy. Results In treatment group after L-CN therapy, CRP and IL-6 significantly decreased (P<0.02), and Hb and Hct significantly increased (P<0.02). When comparisons were made between treatment group and control group after L-CN therapy, CRP and IL-6 also decreased (P<0.02), and Hb and Hct also increased (P<0.02) in treatment group. Additionally, erythropoietin (EPO) dosage reduced in treatment group after L-CN therapy. Conclusion Micro-inflammation and renal anemia improved in MHD patients after intravenous administration of L-CN for 12 weeks.