【Abstract】Objectives To summarize the diagnosis and management experiences for upper extremity edema in hemodialysis patients. Methods We retrospectively analyzed 51 cases with upper extremity edema in hemodialysis patients from July 2006 to June 2011 in our department. Their location of the lesion, method of management, and outcomes were summarized. Results There were 31 males and 20 females with the mean age of 60.18±14.38 years (21-88yrs). Their vascular accesses for hemodialysis (28 cases in left and 23 cases in right) lasted 36.35±28.94 months. The symptom occurred for one month to two years. Duplex and venography were used preoperatively, and 50 stenosis or occlusion lesions and one reflux lesion were identified. The symptoms were resolved by surgical revision, angioplasty, stent or closure of the access.  Conclusions The upper extremity edema resulted mainly from venous hypertension in hemodialysis patients. Combined use of duplex and venography were helpful for the diagnosis of location and extent of the lesions. Central venous stenosis or occlusion was the common lesion. Surgical revision is recommended for the superficial venous lesions. For cephalic arch and central vein lesions, angioplasty or stent placement may be the best choice to decrease the surgical trauma, but the long-term patency rate is low. Therefore, careful surveillance must be carried out.