Objective:To explore the self-care experience of arteriovenous fistula in elderly maintenance hemodialysis patients, and to provide reference for intervention and management.Methods:The descriptive phenomenological research method was used to select elderly patients as subjects who underwent hemodialysis and used arteriovenous fistula as vascular access in the blood purification center of The First Affiliated Hospital of Zhejiang University School of Medicine from November 2022 to May 2023 through objective sampling, and semi-structured in-depth interviews were conducted on them, and the data were analyzed by Colaizzi 7-step analysis method.Results:Finally, 15 interviewees were included. There were 6 males and 9 females, aged (73.53±8.59) years old. A total of 4 themes and 12 sub-themes were summarized: multiple burdens (comorbidities management burden, psychological burden, financial burden), self-care dilemmas (affected by physical decline, inadequate self-coping, inadequate counseling channels), driven by social factors (motivated by social feedback, influenced by peer behavior, promoted by extended medical services) and understanding of life philosophy (actively coping with life changes, replanning life order, appreciating life value).Conclusions:Elderly maintenance hemodialysis patients have complicated burden experience, multi-dimensional problems and needs in the process of self-care for internal arteriovenous fistula, and self-care behavior is greatly affected by social factors. Future intervention should focus on strengthening multidisciplinary collaboration, providing professional and convenient continuous nursing services, improving social support paths and giving accurate psychological intervention, so as to reduce the burden of disease management of patients, meet their self-care needs, enhance the internal motivation of self-care behavior and improve self-care ability.