Background: The best arteriovenous access in diabetic patients under dialysis is crucial to attain better therapeutic outcomes and improved prognosis in the patients. The purpose in this study was to compare the primary patency and maturation rate of antecubital artriovenous fistula for dialysis in diabetic patient with two methods: regional block with Ropivacaine 0.5% and local anesthesia with lidocaine 2%. Methods and Materials: In this randomized clinical trial, 40 consecutive diabetic patients under dialysis in 2016 and 2017 in a training center were enrolled and the primary patency and maturation rate of antecubital artriovenous fistula were compared with regional block with Ropivacaine 0.5% versus local anesthesia with lidocaine 2%. Results: The results in this study demonstrated that all factors of final arterial and venous diameter, blood flow, and patency were higher in group under regional block with Ropivacaine 0.5% and all except patency showed significant difference (P < 0.05). The complications rates were alike across the groups (P > 0.05). Conclusion: Totally, according to the obtained results, it may be concluded that regional block with Ropivacaine 0.5% is superior to local anesthesia with lidocaine 2% leading to higher patency rate and shorter maturation time and also higher arteriovenous diameter and blood flow.