Every year a large number of chronic patients undergo dialysis at dialysis departments in the Slovak Republic. Each one of them is connected to the artificial kidney 100 to 160 times. The most valuable property of these patients is a quality and long-term functioning arteriovenous fistula since it is one of the essential conditions for successful dialysis. The surgeon who creates arteriovenous access must thoroughly examine the patient before the operation, properly evaluate the vascular system and choose the most favourable way of the vascular access for long-term haemodialysis. Patients with chronic renal failure have impaired haemostasis, several of them have diabetes and their vascular system is affected by atherosclerosis. Determination of the operational plan and optimal vascular access is strictly individual and depends not only on the vascular system of the patient but also on the general condition, age and prognosis of the disease. A quality arteriovenous fistula should conform to the requirements of the simplest and the shortest operation as possible, using local anaesthesia. Underestimation of any fact can result in the creation of many non-functional AV fistulas. AV fistulas operations for the purpose of long-term haemodialysis are an integral part and one of the most problematic issues of Vascular Surgery. There are more and more patients who are in the long-term haemodialysis program. The average age of patients is increasing. All these factors have resulted in the need to create more and more AV fistulas because their usability is limited. The correct operational tactics, individual approach to the patient and precise surgical technique of the vascular surgeon contributes to the improvement of the quality of life of sick patients, of whom only a small percentage is so lucky that the disease is cured by successful kidney transplantation.