Objectives: Objectives: Worldwide, malnutrition and inflammation are among the most common forms of complications in maintenance hemodialysis (MHD) patients. However, it is still unknown whether the dietary inflammatory potential is associated with malnutrition-inflammation status in Chinese population undergoing hemodialysis. This cross-sectional study aimed to assess the relationship among them in Chinese MHD patients. Methods: Methods: We evaluated the whole MHD patients in the Hemodialysis Center of Guangdong Provincial Hospital of Chinese Medicine with the following assessments: demographics, anthropometrics, dietary assessment, nutritional assessment and laboratory tests. Dietary Inflammatory Index (DII), a tool for assessing the whole inflammatory potential of the diet, was computed based on a semi-quantitative food frequency questionnaire. Malnutrition-inflammation status was assessed by C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), hemoglobin (HB), albumin (ALB) and malnutrition-inflammation score (MIS). Multivariable liner regression and logistic regression were employed adjusting for covariables including age, gender, body mass index and dialysis vintage. Results: Results: A total of 161 Chinese MHD patients with an average of 60.0 ± 13.6 years were enrolled. The median (IQR) DII score among participants was 0.60(-0.80, 2.32), revealing a generally pro-inflammatory diet. DII was positively associated with MIS score (β= 0.608, p < 0.0001) and CRP (β = 0.544, p < 0.0001). Multivariable logistic regression showed that each unit increase in DII was linked with 3.055 (95% Cl: 1.394, 6.692, p = 0.005) times increased odds of MIS. Conclusions: Conclusions: Diet with a higher DII score may act as a potential trigger contributing to the development of malnutrition-inflammation status. Further studies for verification and for developing strategies to decrease the dietary inflammation burden are warranted.