End-Stage Renal Disease (ESRD) is linked to a high prevalence of respiratory complications, affecting 27.2% of patients, with pneumonia comprising 25% of these cases. Inflammatory biomarkers like the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) are important for assessing inflammation in diseases, including pneumonia, and have emerged as novel mortality predictors. A cohort retrospective study was conducted analyzing hospital records of patients with ESRD and pneumonia admitted to the Nephrology Department of Moewardi Hospital in Indonesia between July and December 2023. Complete blood count (CBC) measurements were performed to calculate the NLR, PLR, SII. Statistical analyses, including Chi-square and logistic regression tests, were utilized to evaluate the correlations between NLR, PLR, SII, and bacterial profiles with mortality rates. Among 46 patients with ESRD and pneumonia, the mean age was 55.46 ± 11.14 years, with 52.2% male and 47.8% female. The main organisms responsible for pneumonia were Klebsiella pneumoniae ss. pneumoniae (23.9%, 11 cases), followed by Pseudomonas aeruginosa (17.4%, 8 cases) and Escherichia coli (15.2%, 7 cases), along with other bacteria at different percentages. The mean values for NLR, PLR, and SII were 17.57 ± 16.98, 344.43 ± 266.91, and 225.68 × 10⁵ ± 54.92 × 10⁵, respectively. Pseudomonas aeruginosa was linked to a 10.9% increase in mortality compared to other bacterial isolates, although this difference was not statistically significant (p = 0.193). Significant correlations were found between mortality and NLR (p =0.007, OR = 0.917), PLR (p = 0.016, OR = 0.996), and SII (p < 0.006, OR = 1.00), indicating that higher levels of NLR, PLR, and SII are associated with increased mortality risk. Elevated NLR, PLR, and SII levels may serve as mortality predictors in End-Stage Renal Disease patients with pneumonia, whereas bacterial type does not.