【Abstract】 Objective To determine the relationship between conventional coagulation examinations and thromboelastograph (TEG) parameters and blockage in internal fistula by thrombosis in hemodialysis patients. Methods We recruited 50 hemodialysis patients in this Blood Purification Center and divided them into the presence of internal fistula embolism group (group A) and the absence of internal fistula embolism group (group B). TEG, conventional coagulation examinations and blood routine tests were measured retrospectively. Results There were no differences in hemoglobin and conventional coagulation parameters between the 2 groups, and the international normalized ratio (INR) was identical between the two groups (0.98±0.05 vs. 0.98±0.09, P=0.48). There were also no statistical significances between two groups regarding activated partial thromboplastin time (33.78±4.85 vs. 32.05±4.15 seconds, P=0.21), prothrombin time (11.92±0.64 vs. 11.90±1.15 seconds, P=0.48) and platelet number (190.7±40.07 x 109/l vs. 189.7±42.01 x 109/l, P=0.04). In the 14 cases in group A, hypercoagulation state was found in 10 patients and hyper-activated platelets in 4 patients by TEG. In the 36 cases in group B, hypercoagulation state was found by TEG in 30 patients, of whom 16 cases also showed increased function of platelets, and 6 cases had hyper-activated platelets and blood coagulation factors. There were significant differences in the TEG parameters of R, K, ANGLE and CI values between the 2 groups, suggesting the presence of hypercoagulation status in group A. Conclusion TEG disclosed the hypercaogulation status more accurately than other conventional coagulation examinations in hemodialysis patients. TEG is helpful for the prediction of thrombosis formation predisposition in internal fistula in uremic patients under hemodialysis.