Objective · To investigate the patency rate of small diameter basilic vein transposition arteriovenous fistula and its clinical application to hemodialysis. Methods · Eighteen patients with basilic vein transposition arteriovenous fistula Mar. 2015 to Mar. 2018 were analyzed retrospectively in the Department of Nephrology, Affiliated Hospital of Guilin Medical University. The diameters of the patients’ basilic veins were allResults · The success rate of operations was 100% in the 18 patients. The fistulas all could be used 6-10 weeks after operations. The hemodialysis blood flow reached 200-280 mL/min, and the puncture length reached 15-20 cm. The patency rates of 3 months, 6 months and 1 year after operations were 100%, 83.3% and 61.1%, respectively. No complications occurred after operations. Conclusion · The basilic vein of forearm with diameter<2 mm can be performed with transposition arteriovenous fistula, and the long-term patency rate is relative high with few complications. It can be used as an alternative surgical scheme when the cephalic vein is exhausted.