In patients with end-stage chronic renal disease who are treated with regular hemodialysis, the vascular access is mandatory. It can be achieved through the catheter for hemodialysis or through construction of arteriovenous (AV) fistula and arteriovenous (AV) graft. Vascular access may be temporary or permanent. Temporary access to the bloodstream includes the appropriate placement of a catheter into one of the central veins (internal jugular, subclavian or femoral). Puncture is performed percutaneously, and it is recommended that the vein is previously visualised by ultrasound. For temporary access, non-tunneled catheters are commonly used. Permanent access to the bloodstream can be achieved using the AV fistula or AV graft, and so-called tunneled or, uncommonly used, nontunneled catheter into one of the central veins. Complications of the vascular access are numerous. Complications of the AV fistula and AV graft are stenoses, thromboses, aneurysms, pseudoaneurysms, cardiovascular complications, infections, and peripheral ischemia of the distal extremity. Complications of catheter for hemodialysis include hematoma at the site of puncture, accidental arterial puncture, inadequate position of the catheter, pneumothorax, hematothorax, hematopericard, thrombosis and infection. For catheter locking at the time of disuse heparin is used most commonly, but recently citrate solutions of different concentrations are being used as well. Adequate catheter care will allow its long-term use.