Objective  To investigate the role of serum transforming growth factor beta 1 (TGF‑β1) in the maturation of autogenous arteriovenous fistula (AVF) in order to provide a potential biomarker for predicting the outcome of AVF function in maintenance hemodialysis (MHD) patients.  Methods The clinical data of 30 MHD patients treated in Jinan Fifth People’s Hospital from December 2023 to September 2025 were prospectively collected. All patients received semi‑permanent internal jugular vein catheterization as the initial vascular access, followed by forearm radial artery‑cephalic vein end‑to‑side anastomosis for AVF construction. Serum TGF‑β1 was measured by enzyme‑linked immunosorbent assay (ELISA) before AVF surgery and after the surgery for 3 months. After AVF surgery for 3 months, brachial artery blood flow and cephalic vein diameter in AVF were measured by ultrasonography. Patients were divided into good AVF function group (n=21) and poor AVF function group (n=9). Serum TGF‑β1 level and its increased amplitude after AVF surgery were compared between the two groups. The correlation between TGF‑β1 and AVF function was then evaluated. Several patients with poor AVF function underwent AVF reconstruction, and serum TGF‑β1 was measured after AVF reconstruction for 3 months.  Results All 30 cases completed the surgery without severe complications during follow-up study. There was no statistically significant difference in preoperative TGF‑β1 level between the two groups (Mann‑Whitney U test, U=92.000, P=0.929). After the surgery for 3 months, serum TGF-β1 level was 356.846±200.492 ng/L in the good function group and 207.099±174.002 ng/L in the poor function group, without statistical difference (t=1.945, P=0.062). However, the amplitude of increased serum TGF‑β1 after AVF surgery was [1.314 (-2.416, 5.044)] in the good function group, significantly higher than that in the poor function group [0.280 (-1.050, 1.610)] (Mann‑Whitney U test, U=44.000, P=0.022). Spearman rank correlation showed that the amplitude of increased serum TGF‑β1 after AVF surgery was positively correlated with brachial artery blood flow (r=0.531, P=0.003) and cephalic vein diameter (r=0.376, P=0.041). In the 5 cases undergoing AVF reconstruction, TGF‑β1 level and its increased amplitude, brachial artery blood flow and cephalic vein diameter were all significantly improved (paired Wilcoxon signed‑rank test for each indicator, Z=-2.023, P=0.043).  Conclusion  The amplitude of increased serum TGF‑β1 after AVF surgery is closely related to AVF maturation and function in MHD patients. In patients with poor AVF function, this amplitude is lower, and becomes higher after successful AVF reconstruction. Therefore, the increased amplitude of serum TGF‑β1 after AVF surgery can be used as a biomarker for predicting AVF dysfunction and as an indicator for an early clinical intervention.