Objective To compare the clinical effect of autologous arteriovenous fistula(AVF)and tunnel-cuffed catheter(TCC)in hemodialysis in patients with chronic renal failure(CRF).Methods In total,112 patients with CRF who underwent hemodialysis from January 2021 to August 2022 were selected and divided into AVF group(undergoing hemodialy-sis using AVF,n =56)and TCC group(undergoing hemodialysis using TCC,n =56)according to different treatment meth-ods.Hemodialysis-related indexes[urea clearance rate(Kt/V),urea reduction rate(URR),blood flow(Qb)for effective hemodialysis],nutritional status indicators,renal function indicators,thromboela-stogram parameters(angle α and k value),serum levels of advanced oxidized protein products(AOPP)and melatonin(MT)before dialysis and at 3 and 6 months after hemodialysis,as well as complications during hemodialysis were compared between the two groups at 6 months after hemodial-ysis.Results At 6 months after hemodialysis,Kt/V,URR and Qb in AVF group were higher or greater than those in TCC group(P<0.01).At 3 and 6 months after hemodialysis,nutritional status indicators,k value and serum MT in AVF group were higher than those in TCC group,while renal function indicators,angle α and serum AOPP were lower than those in TCC group(P<0.05,P<0.01).During hemodialysis,the total complication rate in AVF group(7.14%,4/56)was lower than that in TCC group(23.21%,13/56)(P<0.05).Conclusion The therapeutic effect of AVF is better than TCC in patients with CRF undergoing hemodialysis,which can promote the elimination of metabolic waste,improve nutritional status and renal function,reduce major adverse cardiovascular diseases and osteoporosis.