Background: Hemodialysis is dependent upon the construction, maintenance and preservation of a good vascular access. Objectives: To compare between brachio venacomittant graft and brachio Axillary graft in patients with chronic renal failure with exhausted upper extremity superficial venous accesses, for the purpose of regular haemodialysis, as regard to patency, function criteria (fistula thrill) and complications. Subjects and methods: This prospective randomized study was being conducted on 50 patients with end stage renal disease. It was being carried out at the department of vascular surgery, Al-Azhar University Hospitals (Al-Hussein and Bab-Alsheryah University Hospitals). Cases were being divided into two groups: Group (A): 25 patients were undergone Brachio axillary graft and Group (B): 25 patients were undergone Brachio venacomittant graft. Results: Regarding Access failure, 12.0% at 6 m, in group A. 32.0% at 6 m, in group B, regarding Primary patency, 68.0% at 6 m, in group A. 56.0% at 6 m, in group B, regarding secondary patency, 72.0% at 6 m, in group A. 56.0% at 6 m, in group B. There was insignificant difference between both groups as regard Access failure, primary and secondary patency.