**Abstract**

Patients with end-stage renal disease (ESRD) have an adjusted all-cause mortality rate significantly higher than the general population. Surgical techniques to establish hemodialysis access are common and increasing in frequency as more and more patients are diagnosed with advanced and end-stage renal disease. The purpose of this review is to focus on the fundamentals of perioperative anesthetic management of a patient who is scheduled for hemodialysis access procedure. This involves not only the choice of anesthesia method but also pre-anesthesia preparation, intraoperative and postoperative management, and the effect of choice of anesthesia on the outcomes.

**Keywords:** anesthesia, vascular access, hemodialysis, end-stage renal disease, anesthesia management
