Arteriovenous fistula complications are significant contributors to morbidity in haemodialysis patients and can compromise longevity of the vascular access. This chapter explores common arteriovenous fistula complications including stenosis, hemodialysis access-induced distal ischemia, steal syndrome, infection, and aneurysms. Stenosis leads to reduced flow and access dysfunction, while hemodialysis access-induced distal ischemia can result in distal ischemia. Steal syndrome causes distal limb ischemia due to altered blood flow. Infections pose risks of systemic involvement and aneurysms threaten rupture or skin breakdown. Early detection and management of these complications through clinical assessment and imaging are key to preserving the arteriovenous fistula function and ensuring patient safety in dialysis care.