The aneurisms of the arterioveins anastomosis may be found in 5-6% of the cases with patients on hemodialysis treatment. Usually, they are found around the punctuation places of the outflow vein. No reference data are published to indicate the aneurism frequency within the area of the anastomosis itself. We hereby report about 32-year man with an aneurism found at the place of a functioning termino-terminal, aterio-venous anastomosis, wherein we applied aneurysmectomy, laterterminal radio-cephalic re-anastomosis and skin defect covering by â€œrotation lambâ€ within the area of the forearm. The appropriate professional collaboration between nephrologists and surgeons provides opportunity for applying unusual options for the purpose of preserving the vascular access during the surgery course.