Nutrition education and counseling are important for ESRD patients on maintenance hemodialysis (MHD). We studied impact of education and nutrition counseling on hemodialysis patient’s knowledge, attitude, and dietary adherence. The study used random pretest - posttest control group design and of 77 patients, 38 were man (50.6%) and 39 were woman (49.4%), the mean of age was 46.71 ± 9.40 years old. 41 patients were studied at baseline and after 4 weeks of education and nutrition counseling by dietician and 36 patients were controlled. Patients were counseled regarding intake of recommended protein and calories, and restriction of salt, fluids, potassium, fosfor, and some tips to solve dietary problem. We used leaflet and hand book contains all education material and food record. Patient’s knowledge, attitude, and dietary compliance were assessed on 7th and 10th week to evaluate the impact of education and nutritional counseling. There were increased knowledge (p = 0.0001), increased attitudes (p= 0.0001) and better diet compliance profile (p=0.0001). The intervention was significantly effective on increasing intake of energy (p=0.012) and fat (p=0,0001) and higher difference in protein intake and carbohydrate intake but not significant (p=0,102 and 0,091). Nutrition education and counseling was a process of directing MHD patients towards eating behaviors that fit the diet therapy to meet nutritional needs and to solve underlying problems for change, which were carried out consecutively and repeatedly. Improving energy intake on MHD was important to maintan nutritional status and to prevent Protein Energy Wasting (PEW). The effectiveness of haemodialysis could inhibited by dietary nonadherence mainly due to lack of protein and energy intake that caused PEW. The education and nutrition counselling was found effective on improving knowledge, attitudes, diet compliance behavior profile, energy and fat dietary intake on haemodialysis patients.