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In uraemic patients with low body proteins, healing of the suture line is always a problem with risk of early fail-ure of the arteriovenous fistula (AVF). To tackle this prob-lem, in brachio-cephalic AVF, a fascial flap was interposed between the newly constructed fistula and the cutaneous suture line, at the time of primary surgery. Such a fascial flap will provide a thick covering over the AVF in the event of non-healing of the suture line and thus, avoid any complication resulting from secondary infection due to exposure of the fistula. In addition, the thick viable tissue overlying the fistula will be a good base for taking a split skin graft.