This study included 68 patients with renal failure with male to female ratio of 1.26 : 1 who were subjected to hemodialysis at Cairo University center for pediatric nephrology and transplantation unit in the period between 1/10/2001 to 31/3/2003. It consisted of 15 patients with ARF and 53 patients C.R.F. Vascular access performed to these patients included temporary access: internal Jagular vein, subclavian vein & femoral vein; and permanent access either A.V.F: radio caphalic brachiocephalic & superfilization of the basilic vein or permcath in 2 patients. Complications that occurred in the temporary access included infection (local and systemic) insufficient flow, thrombosis, bleeding and displacement,while complications that occurred in the AVF included infection, primary failure, hematoma formation, thrombosis and occlusion.