Background: With respect to the increasing rate of using arteriovenous fistulas (AVF), current attitude and controversies in different references about constructing A VF in different anatomic sites such as snuff box and radial region; the present study was pyrformed on the CRF patients referring to Shohada Tajrish hospital since 1998 till 2000 to determine the effect of the anatomic site of the AVF on its efficacy and complications. Materials and methods: In this clinical trial, AVF of the case group was constructed in the snuffbox; however, the control group had AVF being constructed in the radial site of the wrist. Fistulas were managed according to the standard side-to-side criteria. The efficacy of fistula was determined through sufficient blood flow and acceptable engorgement ofthe veins of the limb in periods of one (short term) and six months (long term). Meanwhile, complications such as thrombosis, venous hypertension, paresthesia, wound infection, and steal syndrome were all recorded. Finally, statistical analysis was done. Results: 110 individuals, including 80 as the case and 30 as the control group, had entered our study. Groups were matched according to the affecting factors. Short-term efficacy of the fistula was reported 90.5% and 89.7% in the case and control group, respectively, however, long-term efficacy was 94.5% and 95.8%, respectively. (N.S) In the control group thrombosis was recorded in 13.3%, venous hypertension and absence of venous engorgement, each in 3.3%, and paresthesia in 1.8% of the patients, however, in the case group these figures were 13.7%, 2.5%, 1.2%, and 2.5%, respectively. So no significant statistically difference was revealed. In the mean time no cases of wound infection and steal syndrome was reported. Conclusion: The anatomic site of the rasiocephalic AVF in the wrist had no effect on efficacy and complications of the fistula. AV fistulas of the wrist region with acceptable efficacy and few complications are strongly recommended as a favorable vascular access in hemodialytic patients. Further studies "with the aim of comparing this method with other endogenous and exogenous methods would be useful.