Background: Chronic kidney disease is a major public health problem. Vascular access to facilitate hemodialysis is provided by one of the following three options:native arteriovenous fistula, prosthetic arteriovenous graft and central venous catheters. Prosthetic arteriovenous grafts and central venous catheters are associated with lower patency and higher complication rates, infection being the most common complication. Native arteriovenous fistulae are the preferred mode of vascular access worldwide due to its ability to provide high blood flow rateswith superior patency and low rate of complications. Vascular access failure is a major source of morbidity, mortality and expense for patients undergoing hemodialysis. Vascular access sites are what may be described as "expensive real estate ". Every effort should be spent on preserving them as their value can only become more precious the longer the patient remains on hemodialysis. Severaltechniques have been described to maintain a hemodialysis access site; varying from open surgical ones to percutaneous endovascular approaches and sometimes a hybrid combination.Methods: 10 patients with 10 dysfunctional fistulas were suitable for the study. All of them were treated using endovascular techniques.Conclusion: with meticulous pre-operative monitoring and periodic surveillance the chance for access dysfunction will be minimized, and even with detection of access dysfunction percutaneous angioplasty PTA is an effective therapy in restoring the function of failing AVFs.