Objective To compare the dialysis adequacy and complication incidence of different vascular access in hemodialysis. Methods A total of 60 hemodialysis patients treated in our hospital from May 2018 to October 2020 were selected as the research objects. They were divided into three groups according to different vascular access. Thirty patients in group A took autologous arteriovenous fistula (AVF) as the access, and 15 patients in group B took polytetrafluoroethylene graft (arteriovenous grafts,AVG) as the access, 15 cases in group C were treated with dialysis catheter with tunnel and polyester sleeve (tunnel-cuffed catheter,TCC). The levels of hemoglobin, high density lipoprotein, total cholesterol, C-reactive protein, plasma albumin, low density lipoprotein, urea clearance index, triglyceride and urea reduction ratio (URR) were observed and recorded. The patients were followed up for 10 months to observe the incidence of vascular access complications (infection and thromboembolism) in the three groups. Results There was no significant difference in hemoglobin, total cholesterol, high density lipoprotein, triglyceride, plasma albumin, C-reactive protein, low density lipoprotein, urea clearance index and URR among the three groups after dialysis (P>0.05). The incidence of infection and thromboembolism in group A was lower than that in group B and group C, while the infection rate in group B was lower than that in group C, the differences were statistically significant (P<0.05). Conclusions AVF can be used as the preferred way of vascular access in hemodialysis treatment. If the patient's autologous vascular conditions are limited, it can be considered to establish transplanted vascular fistula (AVG) to ensure the adequacy of dialysis, reduce the incidence of complications and improve the dialysis safety and quality of life of patients.