The nursing experience of intimal hyperplasia at buttonhole puncture site in a patient with autogenous arteriovenous fistula was reported.The key points of nursing:to formulate a scientific and reasonable internal fistula puncture plan,to establish and maintain the buttonhole tunnel,to regularly monitor the use of arteriovenous fistula,to replace the traditional internal fistula steel needle(hereinafter referred to as the steel needle)with the hemodialysis trocar needle(hereinafter referred to as the trocar needle)for buttonhole puncture,to treat with far infrared ray during each dialysis,and to guide the patient to apply hirudoid cream on the arm of the fistula side.After careful nursing,the intimal hyperplasia at the buttonhole puncture site disappeared,and there was no recurrence after 6 months of follow-up.