Background: The vascular access for hemodialysis is considered a patient's lifeline. Pain and
bleeding are common problems facing patients with vascular access. So, nurses bear a large deal of
responsibility for selection of cannulation technique whether bevel up or down, to achieve less painful
technique and less bleeding. Aim of the Study: Evaluate the effect of arterial needle bevel orientation on
puncture pain and the post-removal bleeding time among patients on maintenance hemodialysis. Design:
A quasi-experimental research design was utilized for this study. Setting: Hemodialysis unit at Al-Moasat
Alexandria university hospital Subjects: A sample of 50 patients (25 patients in each study group (group 1
/ group 2) who met the inclusion criteria was involved in the study. Results: There was no statistically
significant difference between the two groups regarding level of pain (P value = 0.169), however bleeding
time was lower in patients had their arterial needle inserted in bevel down orientation (P value <0.05).
Conclusion: Insertion of arterial needle for arteriovenous fistula in bevel down was found to be effective
in reducing bleeding time and the need for manual compression, but there were no statistically significant
differences in level of pain with bevel up and bevel down orientation. Recommendations: Replication of
the study on larger probability sample.