Objective To investigate the status of vascular access in hemodialysis patients in our center and evaluate the prognosis of different types of vascular access.Methods The basic data, laboratory test results, vascular access types and prognosis of patients with end-stage renal disease who entered the hemodialysis center of The First Affiliated Hospital of Chengdu Medical College from January 2014 to January 2019 were retrospectively analyzed, and the risk factors of death in hemodialysis patients were analyzed. Results 179 patients with end-stage renal disease without alternative renal replacement therapy before maintenance hemodialysis were enrolled. The average rate of patients who started to use non Dacron catheter was 48 04% (86 / 179). The average proportion of duct with tunnel and polyester sheath was 19.55% (35 / 179). The average proportion of arteriovenous fistula was 32.41% (59 / 179). 29.05% (53 / 179) of the patients in maintenance hemodialysis used the catheter with tunnel. The proportion of arteriovenous fistula was 70.95% (127 / 179). Kaplan Meier survival analysis showed that the patients with internal fistula had a higher survival rate than those with tunnel and Dacron catheter. The multivariate Cox regression analysis showed that the risk of death in patients with tunnel and Dacron catheter was 2176 times higher than that in patients with internal fistula.Conclusion The utilization rate of arteriovenous fistula in patients with primary hemodialysis and maintenance hemodialysis is low. Improving the proportion of arteriovenous fistula in patients with primary hemodialysis and maintenance hemodialysis will be one of the priorities of hemodialysis doctors in the future. The patients with arteriovenous fistula dialysis have better prognosis. Arteriovenous fistula should be considered as the "first choice" of vascular access for dialysis patients, and on this basis, the "individualized" choice should be taken into account.