The management of pain associated with arteriovenous fistula (AVF) puncture is crucial in nursing care and is regarded as one of the most challenging situations that nurses and patients undergoing hemodialysis (HD) face. Aim: evaluate the effect of cryotherapy versus lavender oil inhalation on alleviating arteriovenous fistula puncture pain among Hemodialysis Patients. This study applied Quasi-experimental research design. Setting: The study was carried out in Egypt's Menoufia University Hospital's dialysis unit. Subjects: The study involved a purposive sample of 60 patients receiving hemodialysis with AVF in the aforementioned setting. Three tools were utilized to gather the data; tool I: a structured interview questionnaire, tool II: Visual analogue Scale (VAS), and tool III: Physiological parameters assessment sheet. Results revealed that patients in the two groups (Cryotherapy and Lavender oil inhalation) experienced lower pain during AVF puncture in post application and follow up compared to preapplication. Additionally, patients in the cryotherapy group experienced lower degree of pain during AVF puncture than patients in the lavender oil inhalation group in post application and follow up of both, as the mean score of pain VAS was 2.63 during AVF puncture before application of cryotherapy in the 1^st visit and became 1.56 and 1.16 after application of cryotherapy in the 2^nd and 3^rd visit, respectively. However, the mean score of pain VAS was 2.46 during AVF puncture before inhalation of lavender oil in the 1^st visit and became 1.83, 1.8 after inhalation of lavender oil in the 2^nd and 3^rd visit, respectively. Conclusion: both cryotherapy and lavender oil inhalation positively affected AVF puncture pain among HD patients, but cryotherapy was more effective than lavender oil inhalation on alleviating AVF puncture pain. Recommendations: The application of cryotherapy for HD patients should be considered part of the routine care in HD units for alleviating AVF puncture pain.