OBJECTIVE: Many modifications have been designed for patients in whom unsatisfactory for fistula formation. Among these modified arteriovenous fistula (AVF), the reverse brachiocephalic fistula (rBC), in which the median cubital vein is isolated as close to the basilic vein as possible, then anastomosed end to side to the brachial artery. The result of rBC AVF are assessed in this retrospective series. METHODS: During the period January 2003 to December 2013, a retrospective review of 49 cases undergoing rBC AVF in department of surgery in Soonchunhyang University Hospital were performed. Data collected included demographics, postoperative complications. RESULTS: Primary patency of rBC AVF was 76%, 62.5%, and 50% at 1, 3, and 5 years, respectively. Secondary patency was 100%, 96.8%, and 89.2%, at 1, 3, and 5 years, respectively. Thirty one postoperative complications were developed in 25 patients (65 cases). CONCLUSION: Available techniques for creating rBC AVF are associated with good patency rate. End-stage renal disease with hemodialysis patients might benefit from rBC AVF, because of long patency, less radiologic procedure, and less infection rate.