Background: Although there is debate about the best initial vascular access for elderly patients, Kidney Disease Outcomes Quality Initiative guidelines do not take age into account when deciding the location of autogenous arteriovenous hemodialysis access. Objective: The purpose of this study was to study the outcome of the radiocephalic arteriovenous fistulae in elderly patients, above 60 years of age, as regard primary failure, maturation and non-maturation. Patients and Methods: A single-center prospective cohort study of elderly patients above age of 60 years who were planned for permanent hemodialysis set for primary radiocephalic arteriovenous fistula after fulfilling the inclusion and exclusion criteria during the period from March 1, 2021, to February 28, 2022. Results: During the study period, 83 patients (42 males and 41 females) were included who presented with chronic renal failure (CRF) and were planned for permanent vascular access for the first time. Functional maturation at 6 months was achieved in 66 patients (81.48%). They were significantly younger than those without functional maturation, and the diameter of their radial artery and cephalic veins was, 2.10 mm and 2.50 mm respectively. Also, patients with functional maturity in relation to gender and comorbidities, were not significantly different from those without functional maturity. In the patients, primary, assisted primary and secondary patencies at 6 months were 75.3%, 88.9% and 92.6% respectively. Conclusions: Age has a substantial impact on the functional maturation of radiocephalic fistula in elderly patients, according to this study. This impact should be taken into account when arranging a vascular access in incident elderly patients if they are supported by additional prospective research.