Objective　To compare dialysis adequacy and complications between hemodialysis patients using cuffed tunneled catheter (CTC) and those using arteriovenous fistula for blood access, and to find out a relatively ideal vascular access approach. Methods Patients subjected to an operation of long-term hemodialysis access between July 2006 and July 2007 were enrolled in this study. Dialysis adequacy and complications after the operation were compared in patients using vascular access of arteriovenous fistula (AVF) (n=40) and those using CTC in an internal jugular vein (n=39) in a follow-up period of 36-48 months. Results The duration of using AVF and CTC for blood access was 29.75±10.26 months and 21.48±7.74 months, respectively. Laboratory variables were indifferent between the two groups (P>0.05), except serum phosphorus. Maximal blood flow, blood access usage duration, Kt/V, urea reduction ratio and EF were significantly higher in patients using AVF than in those using CTC (P<0.05). The prevalence of catheter infection, thrombus and death were significantly higher in patients using CTC group (P<0.05). Conclusions Although the prevalence of adverse events was higher in patients using CTC, they still obtained the same dialysis adequacy as those using AVF. CTC is an optimal and alternative vascular access for maintenance hemodialysis patients