【Abstract】Objective To compare the performance of self-sealing vascular access graft (Acuseal) and heparin-bonded graft (Propaten) in hemodialysis applications. Methods The end stage renal disease patients undergoing implantation of prosthetic graft in Haidian Hospital from October 1st, 2016 to December 31st, 2017 were enrolled in this retrospective study. According to the graft type, patients were divided into Acuseal group (observation group) and Propaten group (control group). Early cannulation time, survival rate and access related complications were compared between the two groups. Results There were no statistical differences in age, gender, primary disease, age of dialysis, drugs used, laboratory results and the inner diameter of the anastomotic vessels between observation group (n=45) and control group (n=75). Compared with control group, patients in observation group had shorter early cannulation time (3.0±2.53 days vs. 54.08±23.73 days, P=0.000), lower primary survival rates after 6 months and 12 months (60% and 37.78% vs. 81.33% and 65.33%, P=0.018 and 0.004), lower primary assisted survival rates after 6 months and 12 months (68.89% and 55.56% vs. 94.67% and 82.67%, P=0.00 and 0.001). The cumulative survival rates after 6 months and 12 months in observation group and control group were 91.11% and 88.89% vs. 100% and 94.67% (P=0.293). Access-related complications such as infection, ischemia and pseudoaneurysm were similar in both groups, except 4 cases with layer separation in graft in observation group. Conclusion Acuseal graft allows for early blood access, but its primary survival rate and primary assisted survival rate are lower. The pros and cons should be considered during the selection of prosthetic grafts.