In the last decade, because of significant number of end-stage renal disease individuals in need of renal therapy replacement and permanent quest of nephrologist to optimize kidney disease patients' quality of life, there is an increased interest in achieving a suitable permanent vascular access, essential for an efficient dialysis. Furthermore, it is of high importance to preserve arteriovenous fistula in optimal condition and therefore, it is vital to correctly understand the histopathology and pathophysiological mechanisms implicated in maturation and well function of dialysis vascular access.