Objective: To investigate the efficacy of ultrasound combined with DSA guided balloon dilatation in the treatment of arteriovenous fistula; Methods: Eighty-two patients who underwent maintenance hemodialysis arteriovenous fistula in our hospital from May 2019 to March 2022 were retrospectively opted as the study subjects and divided into the observation cluster (OG, n = 41, healed with color Doppler ultrasound-guided balloon dilatation) and the control cluster (CG, n = 41, healed with digital subtraction angiography balloon dilatation) according to the variances in the treatment methods received. The success rate of puncture, recovery of fistula function and surgical complications were contrasted between the two clusters; Results: The success rate of one puncture in observation cluster was 100. 00% (41/41), which was remarkably upper than 90. 24% (37/41) within control cluster (P < 0. 05). none remarkable variance in the success rate between the two clusters (P > 0. 05). The inner diameter of blood vessel and dialysis flow in observation cluster were remarkably upper than those within control cluster, and there was remarkable variance between the two clusters (P < 0. 05). There were 2 cases of perivascular hematoma in observation cluster, with a total incidence rate of complications of 4. 88% (2/41), which was remarkably fewer than 21. 95% (9/41) within control cluster, and there was remarkable variance between the two clusters (P < 0. 05). Conclusion: Ultrasound-guided balloon dilatation is effective in the treatment of arteriovenous fistula, which can remarkably enhance the success rate of primary puncture, enhance the inner diameter of blood vessels and dialysis flow, and also reduce the incidence of various complications. It has certain value of promotion and application.