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Objective: To determine the frequency of protein energy wasting among end stage renal disease patients on maintenance hemodialysis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from May 2019 to Mar 2020. Methodology: Two hundered patients diagnosed with end-stage renal disease on maintenance hemodialysis were included in the study. Protein-energy wasting was assessed using the Malnutrition inflammatory score comprising four x components: medical history, physical examination, laboratory parameters and body mass index. Malnutrition inflammatory score was used to categorize protein-energy wasting. Results: Out of 200 patients with ESRD on maintenance hemodialysis, 73(36.5%) patients had mild, 120(60.0 %) patients had moderate, and 7(3.5%) patients had severe protein-energy wasting. The advanced age group, multiple comorbid (diabetes mellitus, hypertension, ischemic heart disease), and duration of hemodialysis (> 2 years) had a statistically significant association with the protein energy wasting (p-value < 0.05). Protein-energy wasting was also more prevalent in patients with low monthly income (p-value 0.04). Conclusion: Protein-energy wasting is common among patients with end stage renal disease on maintenance hemodialysis.Old age group, multiple comorbid, and duration of hemodialysis are important risk factors.