Abstract: 【Abstract】Objective To explore the application of intelligent handheld ultrasound diagnostic instrument for the diagnosis of arteriovenous fistula (AVF) status in maintenance hemodialysis (MHD) patients. Methods We recruited 22 MHD patients with complicated AVF treated between October 2016 and December 2016 in the Hemodialysis Center of our hospital as the control group, and 17 MHD patients with complicated AVF treated between October 2017 and December 2017 in this center as the observation group. The AVF puncture for blood access for the two groups of patients was performed by experienced nurses. For patients in the control group, traditional puncture method, i.e. observation first and then blind puncture of the AVF was adopted; for those in the observation group, evaluation, position, marking and puncture of the AVF were conducted by using a intelligent handheld ultrasound diagnostic instrument. The success rate of AVF puncture, pain score, and the rate of puncture-related complications were compared between the two groups. Results The success rate of puncture was 88.77% in the control group and 94.57% in the observation group (χ²=20.609, P＜0.001). The pain score of the observation group was 3.51±2.03, significantly lower than that of the control group 5.07±2.38 (t=3.833, P＜0.001). Subcutaneous hematoma (χ²=17.762, P＜0.001), bleeding at puncture site (χ²=27.333, P＜0.001), and induration at puncture site (χ²=21.056, P＜0.001) were alsolower in the observation group than in the control group. Conclusion AVF puncture with the help of intelligent handheld ultrasound diagnostic instrument can improve the success rate of AVF puncture, alleviate pain, and reduce the AVF puncture-related complications.