This pilot study examined the efficacy of the brachiobasilic fistula formed by a loop of autogenous basilic vein in 15 consecutive patients requiring secondary access. The technique of its construction is also described. The fistula survival at 1 year was 70% and at 2 years was 50%. The major complications were late fistula thrombosis and stenosis. No patient developed an infected fistula or chronic forearm oedema. Fistula assessment monitoring was used to verify the patency of the fistula. This study provides preliminary evidence that this fistula is useful as a secondary access. A randomized prospective study of saphenous vein, basilic vein and polytetrafluoroethylene for secondary access construction would establish the relative merits of these three conduits.