Arteriovenous fistula operations are the most frequent procedures to enhance hemodialysis and to increase quality of life in chronic renal failure. The most frequent late period complication due to fistula is aneurysm. In this study we aimed to present our diagnostic and surgical therapy procedures parallel with literature, in a patient under hemodialysis for four years and having a giant aneurysm which is growing during the last five months as a late period complication at left arm arteriovenous fistula.