The incidence of chronic kidney disease (CKD) is increasing year by year. Continuous progress of CKD may finally lead to end-stage renal disease (ESRD). Maintenance hemodialysis (MHD) is one of the alternative treatments for ESRD patients, and arteriovenous fistula (AVF) is the preferred type of blood access for MHD. However, AVF dysfunction occurs frequently, leading to a short lifetime of blood access. Narrowing of AVF by neointimal hyperplasia is the main cause of AVF dysfunction. Previous studies have shown that both systemic and local treatments may inhibit the intimal hyperplasia. Mesenchymal stem cells have the potentials of diverse differentiation, self-renewal, tissue repair, homing and paracrine activities, probably useful for the reversal of neointimal hyperplasia in AVF. This article reviews recent advances in the mechanism and treatment of AVF dysfunction, the use of mesenchymal stem cells, and the mechanisms underlying the reversal of neointimal hyperplasia, in order to find out new ideas for the prevention of AVF dysfunction.