An Arteriovenous fistula (AVF) is often made for end-stage kidney disease (ESKD) to facilitate dialysis.AVF can be created under general, regional, or local anaesthesia with or without sedation. The choice of anaesthesia technique is based on the patient’s comorbidities, contraindications to regional anaesthesia, the location of the AVF creation, anaesthetic expertise, familiarity, and feasibility. ESKD patients have multiple comorbidities. AVF is typically created in the upper limb. Various approaches to the brachial plexus can be used to block relevant dermatomes to assist in the AVF creation. The dose of local anesthetic needs to be customised as per renal biochemical parameters. We have provided a brief overview of the key regional anesthesia techniques for creating an AVF in patients with end stage renal disease.