Background: Arteriovenous fistula (AVF) is the life-line for the majority of the patients with chronic kidney disease when hemodialysis (HD) is the treatment of choice; it must be followed by necessary instruction to increase knowledge and practice for patients related to AVF care and healing to complete its success and reduce its complication. Aim of the study: to evaluate the effect of implementing educational guideline on clinical outcome of patients undergoing arteriovenous fistula. Study design: Quasi-experimental research design was conducted in this study.90 adult patients were systemic randomly selected from Vascular Surgery Clinic - Mansoura University Hospital to participate in the study which divided into two groups, n=(45 study and 45 control) .Two tools were used for data collection. Patients interviewing questionnaire sheet included two parts socio-demographic data and Interview based questionnaire sheet to assess patient knowledge and practice regarding AVF procedure and Access assessment tool to assess fistula complication. Results: Knowledge of the study group improved significantly after health educational guideline implementation (post test), where P ≤ 0.001and minor of the study group experienced AVF complication. On the other hand there is no improvement of the knowledge of the control group post test, where P = 1.000 and Majority of control group had most AVF complications. Conclusions: Majorities of the control group had unhealthy fistula post test& about one third of them had fistula failure .While the majorities of the study group had healthy fistula following the educational guideline implementation, which indicated the effectiveness of this educational guideline to decrease complications. Recommendation: All patients scheduled for AVF procedure and their families need adequate knowledge and skills to help them to adapt with their life post-AVF.