【Abstract】Objective To explore the clinical application value of venous injection filling combined with modified end-to-side anastomosis in arteriovenous fistula (AVF) surgery. Methods The end-stage renal disease patients treated with autologus AVF surgery in the period from October 2012 to August 2018 were retrospectively analyzed. During AVF surgery, venous injection filling method combined with modified end-toside anastomosis was used in 86 patients (venous injection filling method group), conventional end- to- side anastomosis was used in 43 patients (conventional end-to-side anastomosis group). The vascular suture time, anastomotic length, fistula matured rate after three months, fistula maturation time, and the rate of remedial vascular suture were analyzed. Results The vascular suture time (18.2±4.5 min vs. 21.4±4.9 min; F=14.276, P=0.000), fistula maturation time (33.3±5.4 days vs. 37.7±5.2 days; F=5.179, P=0.031), remedial vascular suture rate (4.6% vs.16%; c2=4.963, P=0.032) were significantly lower in venous injection filling method group than in conventional end-to-side anastomosis group. The anastomotic length [7 (8-6) mm vs. 5 (6-5) mm; z=-7.086, P=0.000), anastomotic stoma fistula matured rate after three months (92.1% vs. 78.3%; c2=4.203, P=0.043) were significantly higher in venous injection filling method group than in conventional end- to- side anastomosis group. The successful rate of AVF surgery had no statistical significance between the two groups (88.4% vs. 86.0%; c2=0.028, P=0.415). Conclusion venous injection filling method combined with modified end-to-side anastomosis has the advantages of shorter vascular suture time, better exposure field, simple and reliable vascular suture, suitable anastomotic length and earlier mature of the AVF, as compared with those in conventional end-to-side anastomosis group. This method is especially suitable for the patients with veins of smaller diameter in autologus AVF surgery.