One hundred and forty-three arteriovenous (A-V) communications were studied in 98 patients on chronic hemodialysis. Four categories of A-V communication were analyzed and compared as to incidence of complications and functional efficiency for hemodialysis. Infectious and thrombotic complications were significantly less in the group of radial A-V fistulas than in the groups of radial artery or posterior tibial artery siliconized-rubber shunts. Brachial A-V fistulas also had a significantly higher incidence of complications. It is concluded that the radial A-V fistula is a superior method of gaining access to a patient's circulation for chronic hemodialysis.