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The effectiveness of hemodialysis is completely dependent on the quality of the patient’s vascular access; thus, appropriate assessment of ateriovenous fistulas and grafts is of critical importance. Point of care ultrasound (POCUS) can be an additional useful skill at the bedside for assessment of the hemodialysis vascular access. In this paper we discuss the basic terminology and techniques that can be employed in the POCUS exam of vascular accesses. We also delineate the current recognized criteria for access maturation and common issues that can be diagnosed with the support of POCUS.