The most frequent dialysis modality in Switzerland is hemodialysis. Patients need a proper vascular access for this modality. There are three types of vascular access for hemodialysis : arteriovenous fistula, arteriovenous graft and central venous catheters. In this article, we will discuss the most important parameters that need to be taken into account when choosing the most appropriate access. We present the advantages and disadvantages of each vascular access, as well as their main local (thrombosis, infection, steal syndrome) and systemic (heart failure, pulmonary hypertension) complications, which may also be encountered by primary care physicians.