Development of malnutrition, inflammation and atherosclerosis are commonly seen in end-stage renal disease (ESRD) patients and the rates of mortality and morbidity are increased by each parameter. The basis of the malnutrition-inflammation-atherosclerosis (MIA) syndrome that has been proposed in 2000 for the first time is the relationship between increased serum levels of proinflammatory cytokine, malnutrition and atherosclerosis that are commonly seen in ESRD patients. The increase of proinflammatory cytokine levels in ESRD patients increases the anorexia and this is known to predispose to malnutrition. At the same time, it is reported that chronic inflammation due to elevated cytokine levels causes accelerated atherosclerosis. The life expectancy and quality of life of patients decreases with the increasing incidence of the components of the MIA syndrome. In this review, we aimed to explain the components of the MIA syndrome, the interactions of these components and effective treatment of each component.