Abstract: Autologous arteriovenous fistula is one of the most important measures to maintain the lifeblood of hemodialysis patients.The incidence and occlusion of internal fistula are one of the most common complications. In this article, vascular sheath ultrasound-guided thrombolysis was successfully performed in the treatment of the arteriovenous fistula occlusion for 96 h. The portable pulsed thrombolysis guided under vascular sheath ultrasound has the advantages of simple operation, mild trauma, accurate thrombolysis, aspiration of partial thrombus, few complications, safe, efficacious and success. This approach is safe and efficacious, which enables urokinase to directly act on the thrombus site. In addition, it is objective under the ultrasound guidance, effectively prolongs the use time of arteriovenous fistula, alleviates the pain and reduces the cost of hemodialysis patients, which is worthy of widespread application in clinical practice.