Objective To investigate the clinical effect of radiocephalic arteriovenous internal fistulas created by anastomosis with two trapezoid and symmetrical lobulated flap. Methods Fourty-four cases were performed operation of anastomosis with two trapezoid and symmetrical lobulated flap in outpatient department. Results The internal arteriovenous fistulas of 42 cases were unobstructed, one fistula obstructed because of vessel crisis, but the second operation was successful. Another fistula was discard because of low blood flow. In 42 cases, the internal arteriovenous fistulas were used well from 3 months to 28 months after operation, and one fistula was punctured 200 times, and it is still unobstructed. Conclusion Anastomosis with two trapezoid and symmetrical lobulated flap for creating internal arteriovenous fistulas is an optional method for maintenance hemodialysis. It decreased the operative time, and improved success rate of internal arteriovenous fistulas.