Arteriovenous fistula (AVF) is the optimal vascular access for maintenance hemodialysis (MHD) patients. Vascular calcification (VC) is one of the important causes of AVF dysfunction, increasing the risks of dialysis inadequacy and death in the patients. Vascular calcification of AFV is a complicated process, resulting from the combined effects of pro-calcification factors and calcification inhibition factors, such as hemodynamic changes, calcium and phosphorus metabolism dysfunction, inflammation, oxidative stress, and others. In this paper, the epidemiological characteristics, pathophysiology, pathogenesis, and prevention of AVF vascular calcification are summarized.