The authors review their experience with 318 direct radiocephalic arteriovenous fistulas created for chronic maintenance hemodialysis over the past six years. Thirty-five of the fistulas (11 %) never functioned or thrombosed within the first month. The early failure rate was significantly different between groups older and younger than fifty years of age (p < 0.05). Moreover, the early thrombosis rate was related to the suture techniques used: 8.62% for the interrupted suture group and 20.63% for the running suture group (p < 0.05). Average patency duration for still functioning fistulas in 120 patients is 38.8 months; for the 58 patients who had late failure it was 14.9 months.