【Abstract】Objective To compare the dialysis adequacy and complications in hemodialysis patients with different vascular access, and try to find out an ideal vascular access approach. Methods Patients who underwent an operation of long-term hemodialysis access between Jan. 2006 and Mar. 2008 were enrolled in this study. Kt/V value and the morbidity of access-related complications were evaluated and compared in a follow-up period of 12～38 months among patients using vascular access of native arteriovenous fistula (AVF), polytetrafluoroethylene (PTFE) grafts, and cuffed and tunneled catheter (CTC) in an internal jugular vein. Results In the 98 maintenance hemodialysis patients, 68 cases used native AVF, 12 used PTFE grafts, and 18 cases used CTC as the long-term vascular access for hemodialysis. Patients accepted hemodialysis by native AVF were younger and had lower infection rate, compared with those used PTFE grafts and CTC as the vascular access (P< 0.01). Thrombosis formation was less in patients with native AVF than in those with PTFE grafts (P<0.01). In patients with CTC, no access thrombosis was found, but inadequate access flow presented in 3 cases. Kt/V value was more than 1.2 in all patients, but was highest in native AVF group (P <0.01, as compared with that in CTC group). Conclusion Patients using native AVF for vascular access for hemodialysis were younger, and had lower rate of thrombosis and infection. Therefore, native AVF is preferable for long-term vascular access. When this type of vascular access is difficult to be established, PTFE grafts or CTC can also be chosen with relatively satisfactory effect of dialysis.