Objective To study the clinic value of 64-row spiral computed tomographic angiography (CTA) for the evaluation of arteriovenous vascular fistula in hemodialysis patients. Methods Fourteen patients with vascular fistula malfunction and without the potential to construct an autologous vascular fistula by clinical evaluation underwent 64-row spiral computed tomographic angiography. Images were processed, and 3-D images were reconstructed by applying maximum intensity projection, volume rendering, and surface reconstruction. Results Based on the 64-row CTA results, arteriovenous fistulas were reconstructed and repaired in 13 patients by surgery under direct view, DSA-mediated treatment or drug intervention. Conclusion 64-row CTA provides important images for evaluation of vascular fistula function and valuable information for clinical management of the fistula.