Objective To investigate the clinical application and the choice of operation pattern for arteriovenous fistula (AVF) in hemodialysis patients. Methods AVFs of various operation patterns were established in 322 hemodialysis patients. The AVF pattern depended on the vascular condition before the operation. Time span for operation manipulation, successful rate, duration for AVF maturation, average blood flow during dialysis, and complications were compared among AVFs of various operation patterns. Results A total of 380 AVF operations were performed in the 322 patients, of which 39 cases had snuffbox fistulas with the patency rate of 92.3%, 280 cases had forearm typical fistulas with the patency rate of 92.9%, 52 cases contained artificial graft fistulas with the patency rate of 98.1%, and 4 cases failed to establish an AVF. Conclusion Every operation pattern of AFV has advantages as well as disadvantages. The choice of AFV operation pattern depends on patient’s vascular condition. Appropriate selection of AVF operation pattern will extend the vascular access function.