As dialysis population becomes older, the need for secondary and tertiary access will grow. This study was done in Tanta University Hospitals from January 1, 2008 to December 31, 2010 to compare outcome, and complication rates of radiobasilic arteriovenous fistula (RBAVF) versus brachiobasilic AVF (BBAVF). Out of 512 patients with chronic renal failure (CRF) the basilic vein was the only available one in 97 patients. RBAVF in the forearm was done in 20 cases (group1) while, BBAVF in the arm was done in 70 patients (group2). The immediate patency rate was 95% in group1 Vs 92.8% in group2. Primary 1-year patency was 75%±6.43 Vs 70.14%±8.94 (P 0.663) in group1 and group2 respectively. There was significant low postoperative complication rate in group1 than in group2 (25% Vs 67% P 0.007). RBAVF represents an important option for vascular access and excellent comparable patency and should be considered when the basilic vein is the only available suitable vein.