The basilic vein fistula provides reliable vascular access for chronic hemodialysis therapy. Early morbidity includes edema and mild pain. Ischemic complications have not developed in this series. Patency has been excellent in the initial period and no patient has yet developed infection, aneurysm or venous fibrosis, although longer follow-up is necessary. The use of the autogenous basilic vein fistula in patients unsuited for forearm arteriovenous fistulae is supported by these results. Long-term results which would support continued use of this modality would include an expected lower incidence of infection due to the absence of a foreign body and the inherent healing property of viable tissue, and improved long-term patency attributable to the absence of a venous anastomosis.