Purpose The aim of the study was to assess outcomes of brachiobasilic arteriovenous fi stula (BBAVF) under ultrasound (US)-guided supraclavicular block with or without superfi cialization and of brachiocephalic arteriovenous fi stula in patients with vessels unsuitable or failed for a forearm fi stula. Patients and methods The study included 75 patients diagnosed with end-stage renal failure. They were divided into three equal groups (n = 25) according to the site of fi stula: group 1 underwent BBAVF (one-stage), group 2 underwent BBAVF (two-stage with 1-month interval), and group 3 underwent brachiocephalic arteriovenous fi stula, all with end-to-side anastomosis under US-guided supraclavicular block. Results There was signifi cant difference in the diameter of arm veins between the fi rst two groups and the third group (P = 0.01), especially using supraclavicular block. Despite group 1 had the longest operative time (82.02 ± 11.39), it had the shortest duration of maturation and the best mean fl ow rate (ml/min) (P = 0.0004 and 0.004, respectively). The frequency of early postoperative complications — that is, primary access failure and early thrombosis (fi rst 10 days) — and late complications — that is, late thrombosis more than 10 days and pseudoaneurysm — was less in group 1 (P = 0.05). Conclusion Despite one-stage BBAVF takes long operative time, it appears to be the most ideal vascular access, with high success rate, shortest duration of maturation, best mean fl ow rate, and less postoperative complications, and surgical redo with its complications is also less especially using US-guided supraclavicular block.