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Patients with end-stage renal disease that require chronic haemodialysis need a reliable vascular access. Unanimously, native arteriovenous fistulae are considered to be the most reliable access for patients with reasonable life expectancy. For the last 60 years arteriovenous fistulae have been created surgically at the wrist or the elbow with variable rates of success, maturation problems, reinterventions and complications, making this field of surgery particularly challenging and full of scientific controversies. The recent addition of the technical ability to create arteriovenous fistulae percutaneously comes to add one more option for the patients and one more source of controversy for the experts.