Hemodialysis access surgery plays a pivotal role in the management of EndStage Renal Disease (ESRD), providing patients with reliable vascular access for regular dialysis treatments. This comprehensive article explores the various surgical techniques used to establish hemodialysis access, including Arteriovenous Fistula (AVF) creation, Arteriovenous Graft (AVG) placement, and Central Venous Catheter (CVC) insertion. Key considerations such as patient selection, preoperative evaluation, postoperative management, and complications are discussed in detail. Understanding the nuances of hemodialysis access surgery is essential for healthcare professionals involved in the care of patients with chronic kidney disease.